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Reduce Rehospitalizations To Increase Referrals

Work with hospitals to keep discharged patients from coming back.

February 10, 2010

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In this issue...

-- Shutting the Door on Readmissions

-- Home Health has an Opportunity to Contribute

-- Increase Referrals by Developing Action Plan to Help Hospitals Reduce Readmissions

-- Leading Home Care Welcomes New Director of Marketing

-- Use Your Next Executive Strategy Retreat to Build Referrals by Reducing Rehospitalizations

-- About the Author

-- Permission to Reproduce

Welcome,

...to Home Health Care Today! the leading electronic newsletter for CEOs and executives of Medicare Certified Home Health Agencies and Hospices.

Home Health Care Today is brought to you as a service of Leading Home Care ... a Tweed Jeffries company. We work with Medicare Certified Home Health Agencies that want to grow the number of medicare referrals that turn into admissions, and with agencies that want to grow their private pay business.


Shutting the Door on Readmissions

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An article in the January, 2010 issue of Hospitals and Health Networks, the journal of the American Hospital Association, talks about how hospitals can improve discharge planning and care transition procedures to reduce the need for patients to come back to the hospital. A recent study by the New England Journal of Medicine found that 20% of fee-for-service medicare patients are readmitted within 30 days of discharge, and 34% go back into the hospital within 90 days.

The calculated cost of avoidable readmissions to CMS is $17.4 billion.

Study authors, including former CMS researcher Steve Jencks, M.D., say that, "rehospitalizations could have been avoided with better planned and executed discharge planning processes, greater follow-up, monitoring of chronic illnesses, and connecting discharged patients to doctors."

Isn't that what we do in home health care? We coordinate with discharge planners. We follow-up with patients. We monitor chronic illnesses. We connect patients coming out of the hospital with their doctors.

The Feds Take Notice

The article in H&HN goes on to point out that the recent debate on healthcare reform has put rehospitalization in the cross hairs of policymakers. The Office of Management and Budget says the healthcare system could save $26 billion over ten years by reducing the frequency with which discharged patients go back into the hospital.


Home Health has an Opportunity to Contribute

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The article in H & HN used two examples of how home health care can play a major role in reducing hospital readmissions. The first is a program at Kaiser Permanente in Southern California. It gave the example of an elderly heart failure patient living alone who had been readmitted to the hospital four times a year for several years. By connecting him to home health care and having him call his nurse instead of going to the hospital, they were able to significantly reduce his returns to the hospital.

The other example comes from the VNS of New York. The largest home health agency in America has developed a Transitional Care Collaborative that reduces hospitalizations by agreeing to see Emergency Room Department patients who don't require admission, and by frequent follow up visits. VNSNY has developed risk screening tools to identify high-risk patients who are more likely to be readmitted. VNSNY readmission rates dropped by nearly 8 percent between 2001 and 2008. Their chronic heart failure programs at Bellview and New York University Hospitals saw reductions of 16% and 12.4%, respectively.


Increase Referrals by Developing Action Plan to Help Hospitals Reduce Readmissions

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In the November 25, 2009 issue of Home Health Care Today, we wrote to you about the focus groups we conducted with hospital discharge planners. At that time, we discussed our observations about how little some discharge planners really understand about home health care, and how home health care can help them reduce rehospitalizations.

We also discussed the perception that hospital discharge planners are not working closely with other departments of the hospital to identify opportunities to save costs and reduce rehospitalizations for specific disease states.

This opens up a huge opportunity for your home health agency to build strong, mutually beneficial relationships with the hospitals in your service area. It becomes a real win-win relationship when hospital executives realize that you can help them reduce costs by reducing the number of patients who come back to the hospital. You can also help them reduce costs by reducing length of stay for patient with specific diseases.

Taking advantage of this opportunity requires an agency-wide commitment to build relationships with the hospitals in your market area, to develop clinical programs that are proven to work, and to create education programs for discharge planners and physicians on how home health care reduces readmissions. Here are seven steps you can take to increase referrals by reducing rehospitalizations:

  1. Identify your areas of clinical expertise
  2. Meet with hospital nursing executives to identify areas of greatest need
  3. Develop clinical programs that will reduce rehospitalizations for specific diagnoses
  4. Explore the use of medical technology such as telehealth to get measurable results
  5. Develop educational programs for hospital staff, discharge planners, and physicians
  6. Design and implement a sales & marketing message to reach out to potential referral sources
  7. Set up regular feedback sessions with hospitals and doctors to review results and communicate outcomes

Our focus groups with hospital discharge planners revealed that having broad goals for reducing rehospitalizations and length-of-stay don't work well. They need to have very specific, focused goals and action plans to reduce rehospitalizations by diagnoses.

You will be more effective in selling your home health services to hospitals and doctors when you have focused, proven, clinical programs targeted at high problem area diagnoses. The more focused you can become, the more success you will have in getting measurable clinical outcomes, and taking that message to doctors and discharge planners.


Leading Home Care Welcomes New Director of Marketing

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Mark KleierWe're delighted to introduce a new member of the Leading Home Care team. Mark A. Kleier joined our company on January 15th as Director of Marketing. In this new role, Mark will work closely with the other members of our team to create programs and services to help you grow your business and get ready for the future.

Mark brings twenty years of experience in marketing and business development from banking, technology, and training companies. His personal experience caring for elderly relatives gives him insights into the opportunities in home health care, hospice, and private duty home care.

Mark will be helping us refine our Home Health & Hospice Business Builders Workshop scheduled for September 15-17 in San Antonio, and he'll be working to refine our process for home health agencies to improve their private pay businesses.

Please join us in welcoming Mark Kleier to Leading Home Care.


Use Your Next Executive Strategy Retreat to Build Referrals by Reducing Rehospitalizations

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Over the past 25 years, we've worked with over 500 different home care organizations to develop strategies to grow their businesses, fulfill their Mission and Vision, and get ready for the future. We've focused on creating competitive advantage in the marketplace in order to take business from your competitors.

One way to create competitive advantage in your marketplace is to develop and implement strategies to partner with hospitals and doctors to reduce rehospitalization. As we said earlier, this takes an agency's wide commitment to focus on patient outcomes and clinical programs. Then it takes a coordinated effort to get this message out through your sales, marketing, and intake teams.

It begins by getting your entire executive team on the same page. When you have your leaders all focused on the same business growth strategy, then you increase the probability that you'll be able to execute with excellence and get the referrals you need that turn into admissions.

Leading Home Care can help you grow your business and get ready for the future by facilitating your next Executive Strategy Retreat. Call Julie Raque at 502-339-0653 to set up a telephone appointment with Stephen Tweed to discuss your agency's growth strategy.

Learn more about The Executive Strategy Retreat


About the Author

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Stephen Tweed, CSP, is Chairman and CEO of Leading Home Care ... a Tweed Jeffries company. For over 25 years he has been a recognized leader in strategy and leadership development for home care companies and associations that want to grow and get ready for the future. He is the author or co-author of five books, four of which were written specifically for the home care industry. He has served on the boards of directors of three not-for-profit home care agencies, and has served as interim President & CEO of a $25 million home care company.

Stephen is a past-President of the National Speakers Association, a 3500 member international society of experts who speak professionally. He is also the father of a 39 year-old son who is physically disabled and uses the services of home care on a daily basis

Grow Your Business, Get Ready For The Future


Permission to Reproduce

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Permission is granted to healthcare publications, associations and companies to reproduce this article in your publication, or to distribute copies to your leaders, on the condition that you reproduce the credits and contact information as follows: "Reprinted with permission from Home Health Care Today. Copyright 2009 Leading Home Care . . . a Tweed Jeffries company. To receive a FREE subscription to this newsletter, log on to www.leadinghomecare.com."



Contact Leading Home Care

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phone: 1-866-209-5101

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