Like Henry Ford in Detroit, Centinela, a 369-bed facility of the Prime Healthcare System, faces specific local challenges. The hospital is in a community where one-fifth of the population (20.1%) fell below the federal poverty line between 2008 and 2012. Some large portions of the population are black or Hispanic, and patients often present with various co-morbidities, Patel said.
During federal fiscal 2013, the first year that the CMS' 30-day readmissions penalties were implemented, the hospital saw a 1% penalty. But the facility saw significant improvement the second year (dropping to a penalty of 0.59%), which they attribute, in part, to the implementation of a post-
discharge phone call program to remind patients about follow-up appointments. Another factor was an affiliation with a local pharmacy that offers delivery services six days a week within a 15-mile radius to help patients without reliable transportation. Despite the success, Patel said, getting to the ideal—suffering no penalty—is not likely to happen.
“There is no way a hospital can control all the variables,” he said. “We've made a small dent, but we're not capable of changing the whole picture.”
That sentiment was echoed by Henry Ford's Nerenz, who said his hospital has initiated partnerships with community healthcare workers who have special training to help local patients with high levels of need, and language programs to help those for whom English is not a first language to improve medication adherence. The hospital received a 1% penalty in fiscal 2013, and improved to an 0.80% penalty for the current year.
“That is money taken away,” Nerenz said, noting that a penalty can equate to hundreds of thousands of dollars.
And the real irony, said Foster of Truven, is that it adds an additional challenge to hospitals that are already strapped.
“Now they have less ability to deal with the problem than they did before,” he said.
Follow Sabriya Rice on Twitter: @MHsrice