The Centers for Medicare & Medicaid Services have placed increased emphasis on avoiding hospital readmissions over the past few years—for good reason. According to the Center for Health Information and Analysis, hospital readmissions cost Medicare $26 million annually, of which $17 million is considered avoidable. What role does nursing home pharmacy services play in avoiding readmissions? First, let’s consider the consequences of a high readmission rate. Three of the six new measures added to the Five-Star Quality Ratings System in July specifically relate to hospital readmissions—and beginning in 2018, Skilled Nursing Facilities will have their Medicare reimbursement rate partially based on those measures. The senior population as a whole is more likely to be admitted to the hospital. In fact, adults 65 years and older make up more than 40 percent of annual hospital admissions. Because of this, a multidisciplinary team effort is required to help long term care residents avoid rehospitalization. Long term care pharmacy providers play a significant role. Pneumonia, asthma, congestive heart failure, pressure ulcers, dehydration and urinary tract infections represent the leading causes of hospital readmission for the elderly population. Among hospital readmissions for those causes, the CMS reports that up to 80 percent of cases could have been avoided if managed proactively. Here’s how LTC pharmacy services can help.
Nursing Home Pharmacy Services Key 1: Clinical ConsultingThere are a number of factors that contribute to hospital readmissions, and many are particularly prevalent among seniors. Clinical factors that can contribute to readmission include:
- Certain conditions, such as COPD, diabetes or heart failure
- Having more than six chronic conditions
- The use of certain medications, such as anticoagulants, antipsychotics and opioids