Reducing 30-day readmissions is hot topic in hospitals these days now that Medicare has attached financial penalties to the statistic. Jackson says it's only a matter of time before Medicaid carries the same stick.
"Certainly 30-day readmissions are the topic of the day and everybody is working to reduce it, not just in their Medicare population," he says. "You will find that when you start changing processes in your hospital or practice that you are going to have spillover to your entire patient population. As you do these handoffs better, hopefully you will be impacting more than just your Medicare population."
The North Carolina study did not include a cost-benefit analysis of transitional programs, although Jackson concedes that "that is the question everybody wants answered."
"What we say in our paper and what is true is that we can be fairly confident that there is a positive return on investment if you just do the math," he says. "When you do transitional care with just six patients you can prevent one admission in a year. Each admission costs $6,000. As long as that is higher than what it costs to manage those six patients for a relatively brief period of time in transitional care, it is a positive return on investment."
Why does transitional care work? Again, common sense provides obvious answers. If you make sure that the patient is following discharge instructions, taking medications, seeing his physician in an out-patient setting, monitoring chronic conditions, etc., of course there will be a better outcome.