Starting this month, El Camino Hospital staff will begin working extra hard to ensure Medicare patients take their prescription medications properly, make it to their follow-up appointments and remain healthy.
It's not that the Mountain View health care organization wasn't doing that before, but now it will be fined by Medicare every time one of its elderly patients is readmitted to the hospital within 30 days of being discharged. The new penalty, which went into effect on Oct. 1, is part of the Affordable Care Act and is meant to encourage hospitals and doctors to strive for quality care over the quantity of care.
The Centers for Medicare Services has estimated that the hospital will not be penalized, said Cheryl Reinking, vice chief of clinical operations at ECH. The hospital "performs statistically significantly above the national average for 30-day readmission rates," Reinking said, explaining estimate. However, she added, readmissions can't always be prevented, so "we're not resting on our laurels.
Even if the hospital is penalized due to something beyond their control, Reinking said the rule is good, because it is forcing her and her colleagues to provide better care for patients.
"The government is pushing us to collaborate and coordinate care outside the walls of our hospital," Reinking said. "We should be doing that. It's what our patients and our community members deserve."
In preparation, the hospital has created some new positions and begun building out technological infrastructure to help patients stay on top of their health.
For starters, thanks to a $500,000 grant from the Gordon and Betty Moore Foundation, the hospital will be able to hire a number of new staff members, including a pharmacist dedicated to explaining medications to elderly patients in great detail. Before, patients would be given their list of medications by a nurse and told to pick them up at the pharmacy. Now, they will be able to go over possible drug interactions and ask questions about what time of day they ought to take their various pills.
The hospital is also working on building a telemedicine network, which will allow elderly patients living in the six nearby skilled nursing facilities to have videoconferencing checkups. Eliminating the need for some in-person checkups will make it easier and more efficient for doctors and nurses to keep tabs on how a patient is doing and make sure they are taking their medication correctly.
"It's just much better to be in the room with them virtually," than over the phone, said Reinking, a registered nurse. "We saw them last and we can pick up on subtle changes."
Reinking said she heard estimates that hospitals can expect to be docked an average of $125,000 in readmission fees in the first year of the new rule going into effect. She was not sure exactly what El Camino is expecting to have to pay. "We're working very hard so that we don't" have to pay, she said.