How a Minnesota hospital is trying to tackle high readmissions

Five-step campaign prevented 5,000 readmissions at 80 hospitals

Fairmont Medical Center and hospitals across Minnesota have collaborated on an initiative intended to reverse their rising tide of readmissions—and their mixed track record illustrates just how challenging it is to control readmissions, the St. Paul Pioneer Press reports.

In 2011, three groups in the Twin Cities launched the RARE Campaign—short for "Reducing Avoidable Readmission Effectively"—to get ahead of the Affordable Care Acts looming penalties for hospitals with high readmissions rates. The campaign targeted five ways hospitals can curb readmissions, including medication management and streamlining care transitions.

As part of the program, Fairmont Medical Center instituted a host of changes. For example:

  • Nurses now spend more time with patients talking about their medications before they leave the hospital and make phone calls to ensure that prescriptions have been filled and follow-up appointments have been scheduled.
  • The hospital recruited a new group of full-time "hospitalist" physicians that have helped improve patient discharges.

The RARE Campaign has prevented more than 5,000 readmissions at more than 80 hospitals across the state, says Kathy Cummings, a project manager with the Institute for Clinical Systems Improvement.

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Readmissions still costly for Minnesota hospitals

Nonetheless, the effort did not save state hospitals from two consecutive years of low marks in the Medicare readmissions reductions program, the Pioneer Press notes. Nearly 30 state hospitals faced penalties of $1.8 million in the program's first year, and the same number saw a collective cut of $750,000 in the second, according to the Minnesota Hospital Associations' Mark Sonneborn.

"We did better this year than last year, overall," he said, adding, "We still have a lot of work to do."

The low marks served as a "wake-up call" for Fairmont, which ranked among the 50 worst hospitals in the nation on excess readmissions, potentially costing the facility more than $80,000 in Medicare payments over a 12-month period, according to Marie Morris, the hospital's medical director.

However, she notes that the 1.51% penalty is based on Medicare readmissions scores calculated during the three-year period ending in June 2012, and the hospital's improvement efforts only began in August 2012. "I think these changes that we've made will show up in next year's data," Morris said (Snowbeck, St. Paul Pioneer Press, 9/2).


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