Reduce Readmission Rates Through Rehabilitation

While hospitals have focused on reducing readmission rates for the better part of a decade, 83% will face readmissions penalties in fiscal year 2020, according to a recent Kaiser Health News (KHN) analysis.1 Penalties cost hospitals more than half a billion dollars annually. One key, and often overlooked, strategy that can help hospitals reduce readmission rates is to have strong post-acute care partners.

83% will face readmissions penalties in fiscal year 2020

Post-acute care partners help reduce readmission rates through patient-friendly care transitions and the application of rehabilitation therapies. In fact, an Issue Brief from the Kaiser Family Foundation cited coordinating with post-acute care providers as one of the key ways for hospitals to reduce readmissions.2

Effective transitions, however, are more easily said than done. Not all hospitals have care coordinators on hand to guide this crucial step, and those that do often lack control of patient behavior and care delivered post-discharge. Studies demonstrate that approximately 80% of serious medical errors involve miscommunication during the hand-off between medical providers.3

With a strategy that includes quality-driven inpatient rehabilitation, hospitals can reduce their readmission rates with the assurance of positive patient transitions and strong clinical outcomes.

Read this guide to understand:

  • The key barriers in reducing readmission rates
  • How rehabilitation is a proven strategy in overcoming these barriers

Barriers to Reducing Readmissions

Many factors outside the hospital’s core services contribute to readmission rates, according to a study published in the Summer 2019 issue of Perspectives in Health Information Management. The study’s authors concluded the biggest barriers are:

  • Poor transitions between care settings
  • Health illiteracy/discharge education
  • Patient socioeconomic factors4

Hospitals must address these challenges to move the needle on readmission rates. The good news is they are not insurmountable. In fact, high-quality rehabilitation provided by a trusted post-acute partner can be a valuable solution that helps hospitals overcome each of these three barriers.

Rehabilitation Therapies Help to Reduce Readmissions

Rehabilitation services are critical to patient recovery as well as reducing hospital readmissions and avoiding financial penalties. Inpatient programs in particular are highly effective in these areas, most notably having a positive impact on preventable readmissions. A study published in PM&R found that only 3.5% of acute care readmissions during an inpatient rehabilitation stay were classified as potentially avoidable.5 This sets inpatient rehabilitation apart from other post-acute settings. Preventable readmissions among the larger population of acute care patients is in the double digits.6

Rehabilitation is so effective because it helps patients improve their functional abilities and successfully transition from the hospital to home. Research published in the Journal of the American Medical Directors Association that reviewed more than 4 million inpatient rehabilitation cases across 16 impairment groups found that functional status was a greater predictor of hospital readmissions than comorbidities.7

Furthermore, according to a study published in JAMA Internal Medicine, impairment seems to correlate to readmission rates, particularly in patients admitted for heart failure, myocardial infarction or pneumonia. The readmission rate for patients who were discharged with no impairments was 16.9% whereas patients who had difficulty with three or more activities of daily living had a readmission rate of 25.7%.8

Getting patients to the highest level of functionality prior to discharge takes commitment to – and investment in – highquality inpatient rehabilitation services.

The Value of Post-Acute Rehabilitation in an Acute Hospital

The value of rehabilitation therapies in improving patient recovery and reducing preventable readmissions is clear, and hospitals have the ability to harness this power. Hospital-based inpatient rehabilitation programs deliver the intensive, interdisciplinary clinical and rehabilitation services necessary for improved function and independence. They enable hospitals to extend their reach and have a positive, ongoing impact on patient care, manage care transitions and improve overall communications – all of which help reduce barriers to reducing readmissions.

In addition, by optimizing the post-acute rehabilitation services provided and expanding access to more patients who can benefit from this intense level of services, facilities can reduce chances of readmissions, keep patients within the health system, and ultimately help patients reach their recovery goals faster and drive greater patient satisfaction.

Case Study: Reduction in Readmissions Through Rehabilitation

Kindred Hospital Rehabilitation Services (KHRS) works with many of the leading health systems across the country to help them provide the highest-quality rehabilitation for their patients. As illustrated below, after partnering with Kindred, hospitals saw a decrease in readmissions.

As illustrated in the table, just one year after partnering with Kindred, hospitals saw a decrease in readmissions
Compares quality the year prior to Kindred management to 2019 quality under Kindred management.

Kindred Rehabilitation Program Client Performance

Before partnering with KindredOne year after partnering with KindredVariance
Percent discharges to community75.4%79.6%4.1%
Percent discharges to acute care8.7%7.7%-0.9%

How Kindred Can Help

As the largest contract manager of hospital-based acute rehabilitation programs in the nation, KHRS removes the barriers of running an effective and efficient rehabilitation unit and helps hospitals reach new levels of operational and clinical success. For more strategies on how to reduce readmission rates or how KHRS can bring greater success, visit www.kindredrehab.com.



To learn more about partnership options that will enhance your program’s success, contact KHRS today.



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References
  1. Kaiser Health News: https://khn.org/news/hospital-readmission-penalties-medicare-2583-hospitals/
  2. Boccuti, C., Casillas, G. Aiming for Fewer Hospital U-turns: The Medicare Hospital Readmission Reduction Program. Kaiser Family Foundation. 29 Jan 2015. http://kff.org/medicare/issue-brief/aiming-for-fewer-hospital-u-turns-themedicare- hospital-readmission-reduction-program
  3. Solet DJ, et al: Lost in translation: challenges and opportunities in physician-to-physician communication during patient hand-offs. Academic Medicine, 2005;80:1094-9
  4. Warchol et al. Strategies to Reduce Hospital Readmission Rates in a Non-Medicaid-Expansion State. Perspectives in Health Information Management. Summer 2019. https://perspectives.ahima.org/strategies-to-reduce-hospitalreadmission- rates-in-a-non-medicaid-expansion-state/
  5. Middleton et al. Potentially preventable within stay readmissions among Medicare fee-for-service beneficiaries receiving inpatient rehabilitation. PM R 2017 Nov. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5670018/
  6. Burke et al. The HOSPITAL score predicts potentially preventable 30-day readmissions in conditions targeted by the Hospital Readmissions Reduction Program. Med Care. 2017 Mar. https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC5309170/
  7. Shih et al. Functional Status Outperforms Comorbidities as a Predictor of 30-Day Acute Care Readmissions in the Inpatient Rehabilitation Population. J Am Med Dir Assoc. 2016 Oct. https://www.ncbi.nlm.nih.gov/ pubmed/27424092
  8. Greysen et al. Functional impairment and hospital readmissions in Medicare seniors. JAMA Internal Medicine. 2015 Apr. https://www.ncbi.nlm.nih.gov/pubmed/25642907