Central PA Medicine Fall 2017 - 13
daup h i n c m s .o
CHOICE TOOLS & RULES
There's a wealth of information available
to help guide patients and loved ones in all
aspects of the decision-making process. For
the first time, Medicare officials have posted
online quality scores for more than 3,800
hospice providers. These public rankings
help consumers make informed choices
about important aspects of hospice care,
plus they encourage providers to improve
Comprehensive information on home
health can also be found at www.medicare.
gov, including a provider ratings guide,
staffing and services, checklists and other
Thirty-seven states (and counting) have
enacted AARP's Caregiver Advice, Record,
and Enable (CARE) Act. This legislation
requires hospitals to help designate a family
caregiver, take steps to notify that person of
discharge plans and teach the caregiver how
to perform follow-up in-home medical tasks.
Many hospitals and SNFs have nurse
navigators, social workers or other professionals who help guide patients before
and after discharge. Referrals from friends,
colleagues and family members can also
be helpful. But a recent national survey by
Advisory Board, a healthcare research and
consulting agency, found that physician
recommendations carry far more weight
in the consumer decision-making processes
than any other source of referral or rating.
Many clinicians have become more
forthright addressing consumer concerns
and questions. This is especially important
in end-of-life situations, when open and
honest dialog helps assure optimum care,
comfort and symptom management for
The trend toward consumer choice has
been instrumental in reducing hospital
readmissions and overall healthcare costs.
In 2012, the Centers for Medicare and
Medicaid Services (CMS) began reducing
Medicare payments for Inpatient Prospective
Payment System (IPPS) hospitals with excess
readmissions. Since inception, hundreds of
millions of dollars have been collected from
hospitals for high readmission penalties.
those age 45-plus strongly agreed with the
statement, "What I'd really like to do is
stay in my current residence for as long as
possible." This is echoed in the last stages
of life, where researchers found that more
than 80% of patients say they "wish to avoid
hospitalization and intensive care during the
terminal phase of life."
Hospitals across the country are doing their
due diligence to keep patients healthy after
they're discharged and reduce the likelihood
they'll need to be readmitted. Those efforts
focus on everything from making sure A TURN FOR THE BETTER
patients experience a fluid transition to outSusan Minarik is the executive director
patient care and take the right medications of Harrisburg-based Homeland Hospice,
as prescribed, to involving caregivers with HomeHealth and HomeCare. "Better
discharge planning and providing them with education and communication are key for
appropriate at-home training.
the continued growth of consumer choice,"
she says. "Some healthcare professionals are
The results are encouraging. CMS reported still hesitant to share frank, detailed patient
that readmissions within 30 days of discharge assessments and realistic treatment options.
dropped in 49 states and the District of Fortunately, the Pennsylvania Healthcare
Columbia between 2010 and 2015, declining Association, its national counterpart, and
eight percent nationwide, or an estimated other industry associations advocating for
565,000 fewer readmissions.
quality care and services are addressing this
dynamic. Improved collaboration between
More recent data confirms these positive providers would be beneficial, as well.
results. Reported in April 2017, research
from the UPMC revealed that healthcare
"Patients and loved ones need to become
organizations that practice meaningful family more pro-active, too. Coping with injury
caregiver engagement and integrate caregivers or illness can be a traumatic, intimidating
into the patient discharge process can reduce experience. Consumers must take the initiahospital readmissions by one-quarter.
tive to stay focused, research their options
and not be afraid to ask questions."
PRESCRIPTION FOR CONSUMER
PROGNOSIS GOOD BUT
Since patients have assumed more of a CHALLENGES REMAIN
consumer role in their own healthcare, hosAll parties involved in the healthcare
pitals and other organizations have needed delivery system have made great strides
to ensure that their patients were happy with in recent years in their respective fields.
their care. Supporting patient satisfaction Consumer choice options have never been
can have a positive effect on a healthcare greater, and support in the decision-making
organization's dynamics, including improving and delivery processes never stronger.
patient retention rates, securing a positive local
reputation and preventing possible malpractice
Patient demand for guidance will only
lawsuits. Empowered, happy consumers increase as clinical options multiply and the
typically experience better outcomes.
world of information continues its rapid growth.
We must continue to correct the underlying
For most consumers opting for home obstacles that impede patient access to needed
health or home-based hospice care services, information. Regardless of circumstances, the
the choice is a fulfillment of their heartfelt patient's quality of life is paramount and we
wishes. Older Americans overwhelmingly must work together to make the best informed
express a desire to age in place and receive decisions possible.
care at home rather than in institutional
Author Todd Owens is a freelance writer. Please contact
settings. An AARP survey found that nearly firstname.lastname@example.org to comment on
three quarters of a survey population of this article.
Central PA Medicine Fall 2017 13
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