Merrily Orsini's Thought Leadership

How Home Health Today Keeps Readmissions Away

It is, unfortunately, a common scenario. An older adult falls (as many as one-third to one-half of us, unfortunately, do; every 11 seconds, in fact). A fracture results, warranting a hospital visit followed by in-patient rehab in a Skilled Nursing Facility AKA SNF (40% of the time). The injured recovers fully and that’s the end of the story, right? If only. The reality is that more than half of us older folks will experience another fall within the next six months. And so, unchecked, the cycle repeats.

There’s a not-so-surprising solution, however, that’s finally getting the recognition it deserves: home health care, especially as an integral and immediate part of the transition from SNF (or hospital) to home. A recent study, “Transitions from Skilled Nursing Facility to Home: The Relationship of Early Outpatient Care to Hospital Readmission” verified what we in the industry already know – that in-home care reduces the likelihood of readmissions. And, if you take that out some, reducing readmissions from a previous fall, is also keeping the recent faller in better health and enjoying life more.

“In fact, a home health visit immediately after a discharge from a SNF was the factor most significantly associated with lower readmission rates,” the study confirms. And while there are certainly monetary benefits to be realized in reducing readmissions, for patients themselves and the SNFs and hospitals who will be penalized beginning in 2018, the brass ring is the reduced risk of harm to the elderly – from that first point of intervention upon returning home, and ongoing, for those fortunate enough to be able to afford or qualify for coverage for those services.

All of which brings me back to my concern over the potential future impact on Medicaid and overall health care changes that seem to be targeting the most vulnerable of our population – the poor, disabled, and elderly. Perhaps when money talks in the form of stiff penalties for readmissions, a solution will be created to do whatever it takes to keep seniors safe and healthy – at home. And, at a fraction of the cost of stays in a hospital. Again, the benefits are far greater than just monetary, as in the myriad other benefits of being in familiar surroundings with loved ones.

Soapbox revisited. I think I’ll stand on this soapbox for a few more years. Healthcare at home finally seems to be gaining the attention it deserves! All this talk about health care requires that each of us demand a system that works for all and does not cost an arm and a leg.

Perhaps focusing on wellness, prevention, self-responsibility, and avoiding hospitalizations/trips to SNFs and looking at the options for care at home will become a part of our revamped heathcare delivery/receiving system.