We recognize that health plans, state Medicaid programs and other health care payers operate under tight budgets, limited human resources and low margins. We also know there is an immense pressure for all payers to find immediate and effective solutions to improve care while containing costs.
eQHealth Solutions can help. Our Care Coordination program is a proven approach that has achieved results quickly while helping hospitals improve the level of care they provide patients and payers improve their medical loss ratio.
These reductions were for heart attack patients and those with congestive heart failure, COPD and pneumonia.
*What’s so bad about unnecessary readmissions?
Unnecessary re-hospitalizations are an indicator of poor health care quality, and many payers are taking steps not to provide coverage when they occur. Across the country the 30-day readmission rate for all non-obstetric patients ranged from 6.3% to 10.7%. The rates are higher for Medicaid recipients than for those with private insurance. It gets worse for aging patients. Within 30 days of discharge, 17.6 percent of Medicare beneficiaries nationally return to the hospital with the same condition. In Louisiana the readmission rate is slightly more than 18 percent.
Not only are patients not getting the care, and after-care instructions, they need the first time, the cost of having to provide another round of the same care is staggering. At the national level, the Medicare Payment Advisory Committee estimates that up to 76 percent of hospital readmissions may be preventable.