Penn Medicine readmissions down 25% under performance-based insurance contract

Philadelphia-based Penn Medicine cut hospital readmissions by one-quarter in the first year of a new type of contract with health insurer Independence Blue Cross, according to Philly.com.

The five-year contract took effect July 1, 2017. Under its terms, Independence no longer pays Penn when patients are readmitted within a month of being discharged.

Penn did not reveal the number of readmissions that had been avoided since its collaboration with Independence.

After Medicare instituted readmission penalties in 2011-12, Penn worked to identify patients at high risk for it, including those with cancer, heart disease, gastrointestinal conditions and sepsis.

High-risk patients were readmitted 16 percent of the time while low-risk patients were readmitted less than 1 percent of the time, Penn found.

Under the new contract model, a scheduler calls patients with a high readmission risk to make follow-up outpatient appointments before discharge.

Penn also developed dashboards to monitor follow-up visits at seven and 14 days after discharge to ensure patients are on track. Most patients now leave the hospital with all their prescriptions to prevent medication delays.

The contract also encouraged Penn to add an outpatient oncology evaluation unit after it found many cancer patients were being readmitted through emergency departments.

"Whenever you implement something new like we did in this program, you expect to learn a lot during the first year, but it usually takes more time to see results like this," said Ralph Muller, CEO of Penn Medicine.

"Through close attention to what our data told us about the patients we needed to focus on, and a dedicated and creative push by teams at both Penn and Independence, we've set a new high mark for reducing readmissions in a far shorter time frame than anyone expected," he said.

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Featured Whitepapers

Featured Webinars