Monday Memo
Monday Memo
Monday, January 25, 2016
What's NEW at Athena Forum

Plan for Discharge Early, Often

A recent article in Managed Healthcare Executive outlined four ways to reduce hospital readmissions:

1. Get better, more timely data

2. Identify high-risk patients

3. Plan for discharge early and often

4. Follow up after discharge

Keeping readmissions down is a critical factor for hospitals and case managers. In 2015 CMS penalized 753 hospitals. Almost 20 percent of Medicare patients are readmitted within 30 days of hospitalization and most of these readmissions are preventable, the magazine reported.

According to the article, not seeing a physician within a week of discharge worsens readmission risk so the hospital should consider actually making the after-discharge physician appointment and following up to remind the patient, rather than just telling the patient to make an appointment.

Similarly, don't just hand the patient prescriptions. Instead, forward prescriptions to a pharmacy that's convenient for the patient, coordinate with the next provider, and give the patient a supply of the medication(s) at discharge.

Discharge checklists can be a big help.

[Managed Healthcare Executive, December 20, 2015 Four Ways to Reduce Hospital Readmissions]


Tips from our featured course

Primary Care Follow-up Reduces Readmissions

Medicare patients readmitted within 30 days of discharge result in annual costs of over $17 billion.

Half of the patients who were readmitted within 30 days had no ambulatory visit prior to re-hospitalization. CMs coordinate connections between the patient and [other components of] HC.

[DC Planning, Module A, Philosophy and Standards]


DC Planning is a Quality Element

To reduce the economic impact of re-hospitalization, future hospital reimbursement increasingly occurs under a value-based hospital payment system. Symptoms reflecting healthcare quality issues include:

  • ED visits for conditions that are preventable or treatable with appropriate primary care --these can lower health system efficiency and raise costs
  • Hospitalizations due to ambulatory care-sensitive conditions (ACSCs) such as hypertension and pneumonia should be largely prevented IF ambulatory care is provided in a timely and effective manner

Evidence suggests that effective primary care is associated with lower ACSC hospitalization, also referred to as avoidable hospitalization.

[DC Planning, Module A, Philosophy and Standards]


Notice from the Publisher

I want to thank our 20,000 healthcare professionals for requesting new topics on Athena Forum.

Thomas A. Rasmussen
CEO & Publisher
Athena Forum Institute

Monday Memo Editor

Cathy Wright, BSN, RN

Clinical Editor

Athena Forum

Contact the Editor


Online CE for RN, CCM & LSW
7,000 pages of clinical excellence.

Clinical Care Series®
» Asthma
» CV Risk: Stroke & MI
» Diabetes Mellitus
» GI Disorders
» Heart Failure
» Obesity Management
» Pain Management
» Sepsis Care
» Wound Care & Payments

Care Management Series®

» CM Express®
» Discharge Planning
» Ethics in CM
» Hospital Revenue Cycle
» Palliative & EOL Care
» Patient Advocacy
» Population Health
» Professional Identity
» Utilization Management

Behavioral Health Series®

» Abuse
» Depression
» Harm Risk Behaviors

Help Desk

Athena Forum Help Desk
Mon-Fri 9am-5pm ET

Enrollment & Passwords
Kristin Hoffman, Registrar

Recommend to a friend
Tom Rasmussen, Publisher

Athena Forum, LLC awards CE for ANCC - NASW - CCMC

Athena Forum is a world wide service mark in nursing education
by the U.S. Office of Trademarks and Patents.