Hunterdon Medical Center Celebrates Success for Reducing Medicare Readmission Rates

As part of their Hospital Readmission Reduction Program, the Center for Medicare and Medicaid (CMS) will penalize hospitals by withholding Medicare reimbursements to those that have a higher readmission rate than determined in 2017.  Hunterdon Medical Center was the only hospital in New Jersey to not receive a penalty.

CMS compares actual readmission rates with expected rates based on patient risk factors for five conditions including: acute myocardial infarction (heart attack), congestive heart failure, pneumonia, chronic obstructive pulmonary disease, and total joint replacements.   If the actual readmission rate exceeds the expected rate, the hospital receives a reduction in their Medicare reimbursement for the next year.  Fines were determined based on data for the period from July 2012 to June 2015.   Each hospital was assessed by what their reported readmission rate was and what CMS determined to be an appropriate rate based on national and demographic information.

“Hunterdon Medical Center has been analyzing our readmission rates and implementing measures to improve them for many years.  Once discharged from the hospital, patients are followed up by a specialist or primary care physician within three to five days after being released from the hospital.  In fact, we are now making these appointments for our patients while he/she is still in the hospital,” explained Robert Coates, M.D., Vice President of Medical Affairs.   Hunterdon Medical Center also uses advanced software to help determine those patients that may be the highest risk for readmission so they can be followed more closely.  The software also helps to determine whether rehabilitation services or home health services are appropriate.

Hunterdon Medical Center works with Care Coordinators in primary care offices throughout the system.  “The Care Coordinators will follow up with patients who were recently discharged from the hospital to make sure medication adherence is being followed and that they are getting the appropriate supportive services needed to keep them on the road to recovery and out of the hospital,” said Dr. Coates.

 

In addition, Becker’s Hospital Review also listed Hunterdon Medical Center in its top 45 hospitals in the country with the lowest heart failure readmission rate.  Hunterdon Medical Center was the only hospital in New Jersey with a listed readmission rate of 18.5%.  The national average is 21.5%.

 

“I am proud to be part of a team that puts our patients at the forefront of everything we do.  Reducing readmissions is  truly a coordinated effort between inpatient and outpatient physicians, advanced practice professionals, nursing, pharmacists, care coordinators, social workers and our support staff,” stated Dr. Coates.

To learn more about Hunterdon Healthcare, visit www.hunterdonhealthcare.org.

 

Caption: Thom Kim Nguyen, PharmD, BCPS, CTTS, Clinical Coordinator, Ambulatory Care at Hunterdon Medical Center works with outpatients at Hunterdon Family Medicine at Cornerstone in Flemington and Hunterdon Family & Sports Medicine at Hopewell Valley in Pennington.  Her role is to work side by side with physicians as a team member and recommend changes or add-ons to medications.  “I see primarily high risk patients to counsel and educate on their prescriptions and over the counter medications, fill pill boxes and help with access to medications,” explained Dr. Nguyen. Dr. Nguyen is part of the team that is helping her patients stay out of the hospital by providing education and frequent follow up visits to address their medication related issues.  Pictured:  Dennis Lamneck, a patient at Hunterdon Family Medicine at Cornerstone, talks to Thom Kim Nguyen, PharmD, BCPS, CTTS, about his current medications after being discharged from the hospital.