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Home / News & IndustryManaged Care Insight and Analysis
Updated: November 9, 2010
Minnesota Providers Fighting Readmission Trend

To reverse a trend of Medicare hospital readmissions right after discharge a hospital, doctors and a health plan in Edina, Minn., have marshaled their resources to tackle the problem head on at Fairview Southdale Hospital. "Nationally, 20 percent of hospitalized Medicare patients are readmitted within 30 days of discharge," said Dr. William Nersesian, CMO of Edina-based Fairview Physician Associates (FPA). "We recognize that some readmissions are unavoidable. However, preventing avoidable readmissions keeps patients healthy and holds costs down."

FPA is a network of 1,200 independent, Fairview employed and University of Minnesota primary and specialty physicians.

Swift follow-up with patients is key to preventing avoidable hospital readmissions, said Dr. Barry Baines, associate medical director of UCare, an independent, nonprofit health plan serving 200,000 members enrolled in Minnesota health care programs, as well as Medicare in Minnesota and western Wisconsin.

Each prevented readmission will keep patients healthier and could save at least $5,000 per patient, Nersesian said.

"This pilot is designed using evidence-based data to reduce variation and establish standardized processes," he added. "We hope to see a 20 percent or more drop in preventable readmissions to the hospital but we will welcome any progress, and will share our learning with the system."

The participants have implemented specific strategies to cut down on readmissions. They are:

  • UCare provides an incentive to FPA primary care providers to see UCare for Seniors Medicare Advantage patients within five business days of discharge from Fairview Southdale. UCare will make sure that patients are correctly taking the right medications, understand what is necessary for good health and what to do if problems arise;
  • FPA nurse case managers will follow up with discharged UCare for Seniors patients in the hospital and by phone to make sure they understand their medications and how to take care of themselves;
  • Fairview Southdale social workers will work with FPA nurse case managers and identify avoidable reasons that might return patients to the hospital;
  • Fairview Southdale hospitalist physicians will urge patients to see their clinic providers within five days of discharge; and
  • Fairview Southdale pharmacists will thoroughly review with patients their current and new medications.

Addresses: Fairview Southdale Hospital, 6401 France Ave. S., Edina, MN 55435; (952) 924-5000, UCare, 500 Stinson Blvd. NE, Minneapolis, MN 55413; (866) 457-7144, Fairview Physician Associates, 3400 W 66th St., Edina, MN 55435; (952) 914-1800,

  This article was taken from:
The Executive Report on Managed Care

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