EvergreenHealth avoids Medicare readmission penalties for sixth straight year

  • Thursday, October 26, 2017 2:42pm
  • Life

EvergreenHealth is the only Puget Sound-area medical center to avoid Medicare readmission penalties for the sixth straight year, according to recently released data from the Centers for Medicare and Medicaid (CMS) and Kaiser Health News (KHN).

The Kirkland-based health system is one of 174 hospitals nationwide to be exempt from readmission fines for the upcoming fiscal year. The new data is based on the re-hospitalization rates for patients with six common conditions: heart attacks, heart failure, pneumonia, chronic lung disease, hip and knee replacements and coronary artery bypass graft surgery.

“This achievement is an important reflection of our health system’s patient-centered approach and commitment to our vision of being the most trusted source for health care solutions,” said EvergreenHealth CEO Bob Malte in a press release. “Our team has dedicated themselves to consistently achieving these positive outcomes and low readmission rates and this latest data reflects our efforts in driving strategic improvements in patient care.”

According to the data for fiscal year 2018, nearly 80 percent of the 3,241 U.S. hospitals CMS evaluated are receiving some form of a penalty due to more patients than expected returning for additional care within a month of their initial stays. EvergreenHealth is just one of seven western Washington health systems to avoid the penalty this year and one of 14 providers to reach this level of readmission rate efficiency statewide.

CMS launched the Hospital Readmission Reduction Program in 2010 to improve the quality of care for Medicare patients by incentivizing hospitals to reduce readmissions within 30 days of a hospital stay. Since the readmissions penalties took effect, hospital readmissions for related conditions have dropped nationwide, KHN reports.

EvergreenHealth’s clinical documentation review process helps the health system to avoid cuts to its Medicare reimbursement and allows the hospital to provide comprehensive care for its patients both in and out of the hospital setting.

To consistently prevent readmissions while delivering higher quality care to the community, EvergreenHealth utilizes the following results-oriented processes:

  • An electronic medication ordering system to improve the delivery of correct medications to patients on admission and discharge;
  • An electronic medical record system that organizes and highlights the necessary resources needed to discharge a patient;
  • Dedicated registered nurse care managers and outpatient service lines for patients with high-risk diagnoses;
  • Evidence-based practices to predict readmission factors for common diagnoses;
  • Mobile technology that equips patients with at-home care instructions and direct access to their rehabilitative care teams.

In addition, EvergreenHealth is also among the Washington hospitals to receive a bonus on Medicaid inpatient claims as part of a state-funded initiative to recognize providers’ commitment to delivering high quality care for the region’s most vulnerable patients, the release states.

Washington’s Medicaid Quality Incentive program rewards hospitals that achieve excellence in a variety of measures — including antimicrobial stewardship, patient falls, maternal health and behavioral health care — that ensure Medicaid patients have access to the highest quality care and services. EvergreenHealth will receive a one-percent bonus on Medicaid claims over the next year for its commitment to excellence in these areas.

“We are acutely focused on being a high-quality, high-value health system that serves the needs of our patients and of our payers,” Malte said in the release. “In everything we do, we are constantly looking to advance the health of our entire community while embracing our responsibility to be stewards of our community’s and country’s health care resources.”

For more information about EvergreenHealth’s commitment to quality, safety and exceptional care, visit www.evergreenhealth.com/quality.

To learn more about the CMS Hospital Readmissions Reduction Program, visit tinyurl.com/z9pfqa4.

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