How to reduce clinic readmission rates

How to Reduce Readmission Rates: 7 Tips

Does your clinic have unreasonably high readmission rates? Are you running out of beds for emergency cases due to an influx of readmissions? 

Readmissions can cost your organization and the people you serve thousands of dollars. From bad ratings to CMS penalizations, there can be long-term effects if your organization does not take action toward reducing your readmission rates.

In this article, we will discuss:

  • Readmissions statistics
  • Factors of readmissions
  • Benefits or reducing readmission rates 
  • 7 Tips for reducing readmission rates

Let’s begin!

Readmissions Statistics 

Both mood disorders and schizophrenia are associated with relatively high readmission rates. In fact, 15% of patients with mood disorders and 22.4% of patients with schizophrenia are readmitted within 30 days.

Data from Robert Wood Johnson Foundation shows about 68% of behavioral health patients have a medical co-morbidity. Meaning they have two medical conditions occurring simultaneously. According to Modern Healthcare, nearly 30 percent of adults with a non-mental health medical condition also have a mental health condition.

So what are the components of your organization that may be leading to these high percentages? 

Factors of Readmission

There are several factors that can lead to a high rate of readmissions such as: 

  • Medication mismanagement
  • Low-quality treatment
  • Poor outpatient follow-up 
  • Confusing transition to outpatient
  • Co-morbid substance use disorders

There are many reasons for readmission rates to increase in the United States. Two of the chief contributors to rising readmission rates are Insufficient Community Support and limited access to follow-up care.

In some cases, patients may not have adequate support systems in their communities to help them manage their mental health conditions after their discharge date. This lack of support can contribute to relapses and the need for readmission.

As for the limited access to follow up care, challenges in accessing timely and appropriate follow-up care can increase the risk. Access to care such as therapy, counseling, or medication management. This may be due to issues like long waiting times, a shortage of mental health professionals, or financial barriers.

Now you may be thinking, re-admissions mean more money for you so why try to reduce them? Keep reading to find out why reducing readmission rates benefits you and the people you serve. 

Benefits Of Reducing Readmission Rates

Readmissions are stressful and costly for the person you serve and your team. The average cost of readmission is about $7,200. 

When you are unable to help address the problems of the person you serve, it can lead to:

  • Decline in their physical health
  • Relationship challenges
  • Inability to keep a job 
  • Suicide
  • Homelessness

When it comes to your organization, high readmission rates can threaten your finances and value-based reimbursements. The Center for Medicare & Medicaid (CMS) has a record of penalizing medical organizations for excessive readmission rates. 

7 Tips For Reducing Readmission Rates

In order to reduce readmissions, there are a few tactics your organization can implement to optimize the experience of the person you serve.

1. Increase Access To Community Resources

In order to reduce readmissions, it is crucial that you improve access to community mental health resources while they are still seeking treatment. Start by informing them of the possible resources so they have time to do their own research and ease the transition. 

One initiative to support the person during their recovery after discharge of mental health treatment is to assign them a peer support specialist. This is a person who had a mental health diagnosis and has been in recovery for at least a year and completed their certification. 

They can foster trust with the person you serve and encourage them to engage in care planning. They can also provide follow-ups to prevent crises when they begin to appear.

2. Promote Patient & Family Engagement 

Promote patient and family engagement in mental health treatment discharge by getting them involved in the planning while the person being served is still admitted. Allowing them to be active in the planning process creates more of a buy-in. 

While caregivers will do most of the heavy lifting, the family should help take charge of managing their care. Family members can help monitor medication, advocate for the person served, and provide social support.

3. Address Co-Occurring Disorders

It is crucial to identify and treat all co-occurring disorders by doing some of the following: 

  • Intake screenings
  • PSYCKES reviews
  • 4-quadrant assessment
  • Motivational interviewing
  • Referrals to providers

It is crucial to do a full assessment of the person you served, even if they come to you with a specific problem. This way undiagnosed issues do not pop up once they are discharged. 

4. Enhance The Experience 

Keeping the person you are serving engaged in their care can help create a better overall experience. Those who aren’t involved are more likely to drop out of mental health treatments, relapse, or be re-admitted. 

In order to increase engagement, include advocacy in treatment by empowering the persons served and giving some autonomy over their recovery plan. 

One way to do this is to have them set goals for their recovery. Another proven tactic is to show the practical outcomes of their care and how it can positively affect their job and relationships. 

5. Improve Communication 

One of the leading causes of readmissions is that there is no cohesiveness between inpatient and outpatient programs. In order to simplify the people you serves’ transition to outpatient, you need to improve communication between inpatient and outpatient resources.

Try to meet with any outpatient providers the person you serve will be working with during their inpatient stay or immediately after discharge. Their involvement in discharge planning  along with any caregivers can help to ensure success. 

6. Create a Clear Discharge Plan

Provide a clear, easy-to-understand care plan that includes medication instructions and scheduling of appointments. Give them a direct point of contact and provide contact information.

Setting clear goals and a defined path toward continued recovery is crucial to the reduction of readmissions. When the person you served feels confused or overwhelmed, it will be easier for them to drop out of treatment and relapse. 

7. Follow Up

Many people served don’t hear from their outpatient provider for months. Often, case management with complex or co-occurring needs can take 60-90 days. 

Your team needs to arrange behavioral health and medical follow-up appointments. Instead of waiting for the next time they come in for a check-up, follow up with a phone call to ensure adherence to treatment and medications. 

Then, you can also troubleshoot any problems they may be afraid to reach out about.

Future Considerations 

  • Put an Emphasis on Mind & Body – Collaboration with general physicians can help stop comorbidity between mental and physical challenges.
  • Create A Patient-Centered Recovery Model – Allow the people you serve to have autonomy over their care to ensure commitment to recovery. 
  • Optimize Your EHRIn order to monitor and evaluate your processes to improve outcomes, you need reliable data across all departments. 
  • Enhance Your Community Programs – The outpatient treatment and long-term recovery of the people you serve rely on support from their community. 
  • Incorporate Assertive Community Treatment (ACT) – This evidence-based unified team approach reduces readmissions for those with severe mental illness.

Reduce Your Readmission Rate with C4 Consulting

Looking to reduce your readmission rate? Our team of consultants are behavioral health experts with years of experience helping organizations like yours.

They have the industry knowledge and tools to support your organization in your efforts to improve your treatment and discharge processes. From clinical program consulting to operational consulting, we can help transform your organization and create sustainable success. 

Our consultants can evaluate your organization to see what factors are contributing to your high readmission rate and create processes to overcome them. Let our behavioral health consulting firm help you change lives for the better and protect your finances.