Home Health Providers Reducing Hospitalizations

November 20, 2006

West Des Moines, Iowa - Home health care allows patients to receive the care they need surrounded by their loved ones in the comforts of home. For many, this is the ideal environment in which to receive care. One goal of home health care is to reduce the number of avoidable hospitalizations for their patients.

The latest round of data shows that more than 30 percent of Iowa home health agency patients required acute care hospitalization during the last year. As Iowa's Medicare Quality Improvement Organization, the Iowa Foundation for Medical Care is focused on improving these rates.

IFMC is working with home health agencies to identify best practices for reducing and avoiding unnecessary hospitalizations. "Not all hospitalizations are avoidable, but by identifying patients at risk, increasing communication and improving care for chronic conditions the number of hospitalizations can be reduced. A strong team of caregivers, home health nurses and other health care providers is one of the best ways to keep home health patients healthy and at home. Strong collaboration and effective communication impacts outcomes and helps patients remain in their home," said Kim Downs, IFMC.

When home health care begins for a new patient it is important to develop a plan that specifically notes signs or symptoms that require a call to the nurse or doctor, or a visit to the emergency department. Teaching these signs and symptoms to the patient, his or her family and other caregivers is an important step. When home health care begins a comprehensive plan of treatment specific to the patient's disease process is developed.

The home health provider collaborates with other health care providers to educate the patient and family on disease processes and promote patient and family self-management. An important step to reducing avoidable hospitalizations is developing an emergency care plan that identifies signs and symptoms to report to the home health provider, the physician or call to 911.

Marcia Schaefer of Stewart Memorial Home Care in Lake City shares their new philosophy; "Our nurses are considering how often we were telling our patients to go the emergency room. Now, we either make a visit or call the doctor and work together on ways we can prevent the patient from being hospitalized."

Keokuk County Public Health is also reducing patient hospitalizations. "When we started looking at the numbers, our patients were being hospitalized more than 40 percent of the time. We identified areas for improvement, increased staff awareness and started monitoring our progress. Our rates are now consistently well below the national average," said Marilyn Waechter.

Financial implications for the patient and the health care system are also factors in the reduction of acute care hospitalization. Reducing acute care hospitalization by only 3% nationwide would result in a reduction of $2.7 billion in Medicare spending every year.

Home health care is often successful because the patient is more comfortable at home than in a clinical setting. This advantage is lost if a change in a patient's condition is missed and he or she requires acute care not available at home. Proper planning, teamwork and education can keep patients where they most want to be, at home.

Media Contacts:
Linda Ruble (515) 223-2107 lruble@ifmc.org

This material was prepared by the Iowa Foundation for Medical Care, the Medicare Quality Improvement Organization for Iowa, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. 8SoW-IA-HH-10/06-070.