Predictive Analytics in Reducing Readmission Rates

One of the best ways for stakeholders including hospitals and clinics to tackle rising healthcare costs and improve patient care is to implement initiatives to prevent hospital readmissions. Research indicates that as many as 15–25 percent of patients discharged from the hospital are readmitted within 30 days. However, many of these 30 day readmissions are preventable and can result in saving billions of dollars.

The Need for Reduction in Readmission Rates

Preventing hospital readmissions benefits both cost and quality where savings can be achieved rapidly as the focus in on 30 day readmissions. There are several reasons for the failure inreducing hospital readmissions. One of the major reasons is that the efforts aren’t data driven in identifying where the problem of readmission exists,or in determining the efficacy of interventions. Another reason is because the focus is on hospital based transitions that do not extend to avoiding 30 day readmissions or helping patients with chronic diseases avoid being hospitalized. However, with CMS penalties and the increasing need for better patient care, it is imperative for hospitals and other healthcare providers to consider reducing hospital readmissions through predictive analytics tools

The role of Predictive Analytics

Predictive analysis is one of the most effective ways of preventing hospital readmissions. It reduces the rate of readmissions and helps healthcare providers develop community-basedprograms. Additionally it can be used to help identify risk patterns and risk assessment stratification. Healthcare solutions providers like Jvion offer predictive analysis software and readmission rate tools, which can play a major role in improving the utilization of resources for high-risk patients. Tools like RevEgis can help providers stratify readmission risks and avoid costly pitfalls. These healthcare cost reduction tools use an advanced patient phenotype model to help hospitals target preventions through actionable insights and stop clinical conditions that lead to financial penalties. Tools like RevEgis not only help cut losses,but help improve the standard of healthcare.

The Role of PSOs in Preventing Hospital Readmissions

Under the Affordable Care Act (ACA), patient safety organizations or PSOs are required to help hospitals experiencing high readmission rates improve their performance. In addition, the HHS or Department of Health and Human Services must lend support to PSOs in helping hospitals reduce hospital readmissionrates. Eligible hospitals are those defined in the ACA as having a high rate of readmissions for specific conditions as described in the Social Security Act. They have not taken appropriate measures to improve patient safety and reduce readmission rates as determined by the Centers for Medicare & Medicaid Services (CMS). However, all hospitals have the freedom to engage PSOs to help with readmission issues.

While using predictive analytics, hospitals can also learn to communicate with patients better and follow up after their discharge. It also helps address the cause of readmission. However, many factors outside the hospitals’ control could also have an impact of the cause for readmission. Making the most of technologies from healthcare solution providers is no longer an option but a must if everyone involved is to benefit. Now, even nurses can make use of discharge education template and personalize them according to a patient’s condition.