4 Ways Hospitals Can Partner with EMS to Reduce Readmission
Hospital readmissions can pose a real problem for health care providers, not only in keeping emergency departments (EDs) packed and overt-stressed, but in driving costs higher and higher, and causing challenges for reimbursements. In fact, thousands of hospitals will be facing penalties in the year to come for higher-than-expected readmissions within 30 days of discharge, including the withholding of payments.
In the battle against readmission and unnecessary ED visits, hospitals have an ally in their local EMS agencies. Not only are EMTs the “boots on the ground” in the community, they can offer a unique perspective on what is causing the readmissions and help identify ways to prevent them. Additionally, new agreements and creative plans can establish new protocols that make EMS agencies an active participant in not only preventing readmission, but improving outcomes and satisfaction ratings (which are increasingly tied to federal funding). For example:
- Improved Protocols for Assessing Pre-Hospital Patients
Hospitals can work with EMS to establish protocols to help technicians clear certain communities that might benefit from treatment other than an ED visit. For example, a patient experiencing a mental health crisis may benefit from being transported to a hospital with appropriate in-patient psychiatric services; otherwise, they may be left to languish for hours in the ED. Arming EMS with the best tools for getting the patient to the right facility improves efficiencies and satisfaction rates, and lightens the load for already-inundated EDs.
- Proactive Assistance to Recently Discharged Patients
Many patients receive follow-up visits from home health care professionals in the weeks following discharge. But it is in those first few days – or even hours – of being at home that many patients experience worry and confusion over medication, side effects, and schedules. Hospitals and EMS can partner to identify patients that could benefit from a proactive visit from EMS to help reconcile medications, ensure prescriptions were filled correctly, and check to make sure medication reminders are properly established. Ensuring that patients are correctly taking their medication and following directions can reduce readmissions and visits to the ED, as well as increase satisfaction ratings for patients and families.
- Population-Based Care
In a similar way, proactive home visits from EMS can target and provide ongoing support for a specific population in a community. For example, patients with longterm health needs – such as congenital heart failure or those entering hospice care – can benefit from EMS services to keep them healthy and out of the hospital, such as help reconcile medication and address any new concerns. These services can help reduce the number of calls for emergency services and subsequent transport to the ED. In these cases, the EMS agency agrees to be paid per patient, per month (or some other time period), rather than number of visits, and can be eligible for an additional incentive-based or contract extension if the program is yielding positive results.
- Mobile Integrated Healthcare
Mobile Integrate Healthcare (MIH) is defined as using patient-centered, mobile resources in the out-of-hospital environment to help reduce hospital admissions and improve community health. This may include providing telephone advice to 9-1-1 callers instead of resource dispatch; providing community paramedicine care, chronic disease management, preventive care; offering post-discharge follow-up visits; and transporting to a wide range of care providers rather than just hospital EDs. To fully utilize MIH, hospitals can sit down with local EMS agencies and perform a community health needs assessment. Once biggest needs facing a community is established, a plan can be created to determine who can provide services at various stages of contact with patients to reduce readmissions and improve outcomes. Additionally, it may be worth bringing in representatives from your state’s Medicare and Medicaid department, as well as large insurance groups, to discuss other partnership opportunities.
Partnering with EMS is a win-win situation for hospitals. It frees up their ED to focus on patients in true emergency situations, helps ensure readmission numbers stay low and accurate, and improves outcomes and patient satisfaction rates, all of which positively impact the operating budget of an organization. By working together to deliver more efficient and proactive care, communities stay healthier and all providers are able to deliver the most effective care to those who need it the most.
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