|By John Murawski, The News & Observer (Raleigh, N.C.)|
The Clayton grandmother, weakened by a failing heart and obstructed lungs, wasn't home even two weeks after the first hospital stay before returning to
To ease the financial sting, hospitals increasingly are trying to manage patients' health care after they are discharged. Hospital personnel make follow-up calls, schedule doctors' visits and set up therapy appointments.
Hospital administrators say the pressure to reduce readmissions is forcing them to take steps that are long overdue -- by coordinating with nursing homes and family caretakers to treat health problems early, before they blow up into emergencies.
King saw a difference at Wake-Med on her return visit.
"This time when I came back in, it was more focused, it seemed to me," King said from her
The penalties in the federal health care law are designed to reduce unnecessary costs and curb waste. Chronically ill, elderly patients, typically on fixed incomes, are among the costliest in the system; some rotate in and out of emergency rooms as a way of dealing with poor health.
But industry advocates warn of a potential downside: Struggling hospitals, spooked by the prospect of huge penalties, could develop an unhealthy fixation on finding ways not to readmit patients who need hospital care.
Already hospitals nationwide have seen an uptick in patients being steered to observation beds rather than getting admitted, Foster said. Hospitals in economically distressed areas with limited health care options are most likely to readmit patients and pay penalties for doing so, she said.
"It's hard to think there will be a financial penalty against your organization to do the right thing by your patient." Foster said. "We don't think that hospitals that serve impoverished, safety-net communities should be penalized because those communities lack the necessary resources."
Readmissions are only one of several factors the federal government is tracking to reduce the cost of health care. All told, within several years hospitals could face up to an 8 percent reduction in