How to Apply “Two-Midnight” Rule to Reduce Readmission Rates

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TL;DR
The Centers for Medicare and Medicaid is reviewing or eliminating certain rules that may be contributing to incorrect hospital readmission rates.

The “two-midnight” Rule

The Centers for Medicare and Medicaid (CMS) had suggested a “two-midnight” rule which would treat patients who need care for less than two midnights as outpatients. This was originally to be enforced in October 2013, but has been delayed to March 31st, 2015. However, CMS is now considering eliminating the rule altogether.

The rule was introduced as a response to hospitals categorizing patient visits as under “observation” since the status wouldn’t include them in readmission rates. However, the correct steps should be taken to reduce readmission rates overall.

Some strategies suggested in a recent article include:

  • Understanding patient risk. Providers should be aware of how at-risk a patient is for readmission based on their diagnosis, treatment, etc. Hospitals can understand the patient’s likelihood of readmission using a risk stratification methodology.
  • Predetermined intervention. As soon as a patient is identified as at-risk, certain interventions should occur. These can be follow-up calls, transportation, or any additional services the patient may requires post-discharge.
  • Post-acute care. After leaving a hospital, a patient may still be in need of follow-up care such as a rehab facility, physical therapy, counseling, etc. Having the hospital arrange these services will make it easier for patients to adjust.
  • Using technology for efficiency. There are automated solutions that can quickly collect the necessary information and distribute it to patients so that they’re informed about their options and can quickly set up any post-acute care they may require.
  • Follow-up. Providers should be sure to schedule follow-up visits with patients in order to continue monitoring them so that if any extra care is needed, it can be administered immediately.

Following these tactics is the best way to reduce readmission rates, care for patients, and ensure that they’re on the right track to a healthier status.

Author: Apoorva Anupindi

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