New federal policies penalizing hospitals for high readmission rates have generated a fair amount of debate in D.C. and around the country. No regulation is universally loved, nor universally abhorred. While we can bicker over the nuts and bolts of the regulation itself, there's no doubt that the heightened attention to the problem has been generally positive for the nation's health care system.


It used to be that I would get a trickle of reports or releases or calls about readmissions. When we did this cover story way back in 2008, the issue was just percolating up the chain to the C-suite. MedPAC and others were turning their analytical eyes to a problem that, at that time, was estimated to account for nearly one-third of health care expenditures. Now, hardly a day goes by when I don't get a dozen or so pitches about some innovative way to reduce rehospitalizations. It comes up in nearly every interview, regardless of the subject — health IT, patient engagement, clinical integration, finance, staffing, strategic planning, and so on.

Two weeks ago, the Journal of the American Medical Association dedicated an entire issue to the topic. In a podcast, JAMA Editor-in-Chief Howard Bauchner, M.D., said the issue came about "organically" because they had "a number of papers submitted that focused on the 30-day readmission issue that has become so prominent with respect to CMS and Medicare reimbursement." I wrote about one of those reports, which looked at the role QIOs and community outreach can play in improving care transitions.

This week, two other interesting items came over the transom that caught my eye:

  • The Robert Wood Johnson Foundation announced the five winners of its "Transitions to Better Care" video series, part of the organization's Care About Care project. More than 100 health care organizations submitted videos highlighting their efforts to reduce readmissions. What jumped out at me as I watched the five winning videos last night was the consistent theme of patient engagement. At each of the hospitals, involving the patients directly in their post-acute care was a critical element. Jennifer Williams-Salifou, a nurse care manager, summed it up best in a video for Northern Piedmont Community Care, Durham, N.C.: "The biggest thing I'm doing is teaching patients. Teaching them about their meds, their bodies, their diagnosis; how they got to this point and how they can get out of wherever they are." Some of the videos are slick, others not so much, but there are some powerful messages in all of them, and what seem like some very transferable best practices. (I should also point out that the American Hospital Association recently issued a report on patient engagement, something we blogged about last week as well.)
  • The AMA yesterday released a report outlining the role physicians in outpatient settings have in caring for patients being discharged from the hospital. "When a patient leaves the hospital to go home, they are transitioning back into the care of their outpatient primary care and specialty physicians," said AMA President Jeremy Lazarus, M.D. "These physicians play integral roles in helping patients fully recover, and coordination between inpatient and outpatient teams is key to ensuring success." The report notes that there's a fair amount of study on transitions of care on the inpatient side of the equation, but research on the ambulatory side is "less well-developed."

As some readers may recall, my family had its fair share of challenges with readmissions a couple of years ago. So, at least from a personal standpoint, it's encouraging to see innovative solutions coming to the forefront. What's happening in your market? Click on the comment link below and let us know.