CAPSULES
Joint Effort Continues to Reduce Hospital Readmissions A pilot program to reduce hospital readmissions continues to exceed expectations, according to officials involved in the project. Two years after Fairview Health Services and UCare began the program, readmissions to two Fairview hospitals of enrollees from the UCare For Seniors Medicare Advantage health plan has dropped to at least half the national average. The program, a joint effort between UCare and Fairview Physician Associates (FPA), involves seniors who are admitted to Fairview Southdale Hospital and Fairview Ridges Hospital. So far, about 2,000 patients have taken part in the program. UCare estimates it saves $10,000 with every prevented readmission. The pilot project is designed to keep patients enrolled in UCare for Seniors Medicare Advantage from returning unnecessarily to the hospital within 30 days of discharge.
Seventeen FPA-member independent and Fairview-owned primary care clinics are participating in the pilot. Initially, FPA hoped to see a 20 percent reduction in readmissions. In fact, nine months into the project, efforts show between a 30 percent and 44 percent reduction, depending on measurement and definition of readmission, says William Nersesian, MD, FPA chief medical officer. “No one really knew how far we could reduce readmissions,� Nersesian says. “I was hoping for twenty percent, but we’re in the high 30s and low 40s.� Nersesian says the key to Fairview and UCare’s success is a 3-pronged approach that includes relatively quick followup visits to a patient’s primary care physicians in the week following discharge; an approach to pharmacy coaching that includes pharmacists going over all medications with the patient; and care managers that discuss issues with patients such as nutrition and transportation to
physician appointments. In addition, hospitalists with FPA now dictate their discharge summaries the day of discharge. This, Nersesian notes, seems like a simple thing but was not always done in the past. “Getting the discharge summary with complete information emailed out to the personal physician is an important part of the process,� he says.
State Ranked High In AHRQ Report Minnesota received the top overall score and was rated “strong� in health care quality by the federal Agency for Healthcare Research and Quality (AHRQ) national report. The agency’s annual stateby-state report finds that Minnesota does very well in the areas of cancer, diabetes, heart disease, and respiratory disease. For maternal and child health, along with home care, Minnesota rated below average. The state ranked first in the nation for flu vaccination among adults with diabetes and
second for both preventing pressure sores among nursing home residents and pneumonia vaccinations for adults older than 65. Its lowest rank was 44th in the nation, for vaccinations of young children.
Asthma Report Finds Higher Rates In Twin Cities A new report on asthma in Minnesota finds that some trends are encouraging but that the Twin Cities area still has a much higher rate of asthma cases than the rest of the state. “The good news is that hospitalizations have been trending down and that Minnesota has a lower prevalence of asthma than the nation,� says Minnesota Commissioner of Health Ed Ehlinger, MD. “But we need to do more to address this troubling difference between the Twin Cities and greater Minnesota and to make sure that children and adults are getting the most effective asthma care available.�
Non-surgical treatment of Varicose Veins • Spider Veins • Venous InsufďŹ ciency Varicose Vein Signs & Symptoms: s ,EG PAIN s "URNING s )TCHING s (EAVINESS
s !CHING s #RAMPING s 4IREDNESS s 3WELLING
• Covered by most insurance
s 3ORES THAT DON T HEAL s $ARKENING OF THE SKIN s 2ESTLESS ,EGS s .UMBNESS
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Before
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(including Medicare & MHCP)
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An estimated 60% of women and men suffer from vein disorders.
Hutchinson • St. Cloud • Chanhassen • Blaine • Lakeville • Oakdale • Brainerd • Duluth 4
MINNESOTA PHYSICIAN AUGUST 2012