Hospital Works To Lower Readmissions

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ROCK SPRINGS — Lowering patient readmissions is one of several goals Memorial Hospital of Sweetwater County has targeted to keep area residents healthy.

The hospital has made strides to lower readmission rates since 2013, when it was one of 14 hospitals in Wyoming to implement the Care Transition Program.

The Care Transition Program ensures the coordination and continuity of health care for patients discharged from the hospital or transferred between different locations or different levels of care, according to Patty O’Lexey, Care Transition Nurse. Today, Sweetwater Memorial is one of only a few hospitals in Wyoming that has continued the Care Transition Program.

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In addition, Sweetwater Memorial, along with Mountain-Pacific Quality Health, organized a Care Coalition Work Group comprised of numerous healthcare entities from the community that meet regularly to discuss readmissions and other healthcare issues, she said.

“Readmissions affect the entire healthcare community,” she said. “Sweetwater Memorial’s dedication to building relationships with area physicians, home health agencies, skilled nursing facilities and other healthcare workers in Sweetwater County, has contributed to lower readmissions.”

Most recently in 2018, Sweetwater Memorial and Castle Rock Medical Center were the first communities in the state to launch the Chronic Care Management Program. The program is a community approach to healthcare with a critical component of primary care that contributes to better health for people with multiple chronic conditions.

Sweetwater Memorial recently was among nine hospitals in Wyoming that will receive reduced payments from the federal government as a result of its readmission rates compiled through the Hospital Readmission Reduction Program.

Ranked second lowest on the list of readmission payment reductions, Sweetwater Memorial received a 0.07 percent reduction of inpatient Medicare reimbursements for fiscal year 2019. It is the smallest reduction of payments the hospital has received in the past five years for readmissions.

 

Sweetwater Memorial received the notification in August 2018 of the Hospital Readmission Reduction Program (HRRP) and the Hospital-Acquired Condition Reduction Program results. Kaiser Health News recently announced the findings. The information can be found at khn.org or the Hospital Compare Program at medicare.gov/hospitalcompare.

Although Sweetwater Memorial did receive a payment reduction for readmissions, it is important to note that it did not have a hospital-acquired condition penalty.

“After reviewing the data, it’s apparent that Sweetwater Memorial continues to make great strides in the quality of care it offers to area residents,” said Ron Cheese, MHSC Patient Financial Services Director.

“Lowering readmissions is a complex group effort that we can’t credit to one thing, nor could we blame one thing when it is high,” O’Lexey said. “It’s not about the readmissions, it is about the patients and their families. That is why we have decreased readmissions, we focus on the patients.”

“We are proud that the changes we have made are reflected in our decreased readmission rates, and ultimately better patient outcomes,” said Kara Jackson, MHSC Quality Director.

“Sweetwater Memorial has worked very hard over the last few years to lower our readmission rates,” Jackson said. “Our rates have consistently trended down and are under national and state averages, which is reflected in the hospital’s recent four-star rating.”

The actual hospital readmission rating falls under the Hospital Readmission Reduction Program, which is a piece of the Hospital Inpatient Quality Reporting Program.

HRRP was started in 2012 as a way of providing hospitals with the opportunity to improve the quality of care provided, Jackson said. This program is intended to incentivize hospitals to reduce excess readmissions.

Here’s how it works:

A readmission means that a patient was admitted to Sweetwater Memorial, discharged and then readmitted to the same or another hospital within 30 days.

HRRP calculates the hospital’s excess readmission ratio for six conditions/procedures: Acute myocardial infarction; heart failure; pneumonia; COPD; CABG, which is a heart surgery not performed at MHSC; and total hip arthroplasty and total knee arthroplasty. That information is used to determine a payment adjustment.

Sweetwater Memorial received a small payment reduction — 0.07 percent — in its inpatient Medicare reimbursements in fiscal year 2019 due to the readmission reduction program results.

“Keeping these readmission rates low is a team effort,” O’Lexey said. “The hospital’s readmission work group is made up of multiple departments and staff members. But it doesn’t end there. Partnerships with healthcare services county-wide are an important part of the process.”