SCAN Health Plan Offers Seniors Five Tips to Avoid Hospital Readmission

Date Posted: 06/02/2013

One in Five Hospitalized Seniors Return Within 30 Days; Much Discomfort and Cost Can Be Reduced Through Following Basic Steps of Understanding and Common Sense (LONG BEACH, Calif.) — Nearly one in five seniors who are hospitalized return to the hospital within 30 days, according to a recently released report by the Robert Wood Johnson Foundation. These readmissions are not only often physically and mentally debilitating to the seniors and their families, but contribute greatly to avoidable and unnecessary expenses on our nation’s healthcare system. In an attempt to help curb these numbers, SCAN Health Plan is offering seniors “Five Tips” to lessen the chance of readmission. “The cost associated with hospital readmissions in America is $97 billion annually, of which $27 billion are Medicare expenditures,” says Romilla Batra, M.D., vice president and medical director of SCAN. “Yet a February 2013 study published in the Journal of the American Medical Association found no link between readmissions and improved health outcomes. That tells us that many of these readmissions can and should be avoided if seniors follow five easy steps.” Ask questions before discharge. When you’re in the hospital, you’re completely dependent on others for care. But once you’re home, you are in charge of your recovery, which makes understanding what to do the key. Patients being discharged from the hospital who ask questions and who have a clear understanding of their after-hospital care instruction are 30 percent less likely to be readmitted or visit the emergency department than patients who lack this information, according to a recent study from the Agency for Healthcare Research and Quality. Understand your medications. This is particularly important if there have been changes to your medication regimen while in the hospital. Upon discharge sometimes dosages are changed or a drug is discontinued or added. Be sure. Write it down. And be sure to fill all new prescriptions once you’re home. Make a plan for follow-up care. Know when to schedule a follow-up visit to your doctor, and make sure you have the transportation to get there. Even if you’re feeling good, go anyway. Your doctor needs to see you to track how you’re doing and gauge whether the treatment plan is working. In addition to doctors, do you need to schedule home healthcare with a nurse or therapist; or do you have some new durable medical equipment or home-modification needs? Communicate with your care coordinator. Whether you have a professional in-home caregiver, a family member nearby, or reside in an assisted-living community, make sure your caregiver is up to date on your recent hospitalization and how you are feeling. This also goes for communicating with your health plan as many have programs and professionals in place that can assist with care coordination. Be aware of “red flags” or complications that should be reported. What is considered “normal” for your post-hospital condition? What degree of pain or swelling is expected? Know what to look for, whom to call if you are not feeling well, and have a clear plan of action in place so you know how to respond to a complication. Dr. Batra says that readmission rates for seniors can also be reduced by enrolling in a health plan that has a strong emphasis on integrated care and care management. She points to a 2012 study released by Avalere Health that compared 30-day all-cause hospital readmission rates between California dual-eligible (Medicare and Medi-Cal) individuals in traditional Medicare vs. those enrolled in SCAN Health Plan. The independent study found that SCAN’s dual-eligible members had a hospital readmission rate that was 25 percent lower than those in fee-for-service. “Industry-wide efforts are underway to bring down readmission rates including new rules passed as part of the Affordable Care Act that charge additional fees to hospitals with excessive readmissions,” said Dr. Batra. “But ultimately it is still the consumer themselves who can play the biggest role through common sense and following these five easy steps.” For 35 years SCAN Health Plan has been focusing exclusively on the unique needs of seniors and others on Medicare. The company currently has nearly 145,000 members in California. Further information may be obtained at or on Facebook at Y0057_SCAN_7954_2013 IA 05282013