Looking for Ways to Decrease Senior Readmissions Under ACA

zintro seniorsLeading researchers at the University of Southern California, Stanford University, The Harris School at The University of Chicago and Precision Health Economics, recently studied the relationship between the use of oral nutritional supplements and the health of Medicare patients. The study found that “the use of oral nutritional supplements decreased the probability of 30-day hospital readmission, length of stay and costs among hospitalized Medicare patients aged 65 and over.” Hospitals are currently looking for ways to decrease readmissions to prevent fines and penalties under the Affordable Care Act (ACA).

Medical marketing professional Debra Zwiefelhofer is an expert on the nutrition and healthcare industry. She started Nutrition Affairs, to provide business to business consulting on nutrition, health, and wellness topics. She explains, “Will this study affect the use of nutritional supplements in hospitals with Medicare patients?  The short answer is ‘probably not.’ This research is not new news, nor is it the first to show a correlation between improved nutritional status and better outcomes. A 1997 study concluded that for every $1 spent on medical nutrition therapies, a savings of as much as $10 can be realized on healthcare costs. The issue behind the opportunity is multifactorial and reflective of all the dysfunction inside the four walls of a hospital. It starts with the budget battles about who is going to pay for the supplement. It further deteriorates with the fact that many physicians lack nutrition education, experience with, and/or belief in that fact that nutrition makes any difference. The icing on the cake is that the registered dietitian, who is the highly trained nutrition expert, is still viewed as ‘kitchen help’ rather than a key resource and contributor to patient care.”

In response to the research about the reduced number of hospital readmissions for those over 65 with intake of oral supplements, Jeannene Davis, a registered and licensed dietician says, “I agree. However, this is also a sign and symptom of these individuals not receiving adequate and appropriate food and assistance in the preparation of that food to meet their physical needs and social needs given their debilitated state.” In terms of what needs to be done after seniors are released from the hospital, Davis says, “If the US could honestly pull together and ensure that our seniors went home with knowledgeable community and family support to provide them with appropriate and adequate nutrition intake, these individuals would likely not be readmitted to the hospital. I find when these same individuals have a required RD consult along with a family member who will be responsible for making the food available, these individuals do tremendously well with food and don’t necessarily have to have the supplements. However, it is so typical that our seniors cannot cook, shop, afford, and do all that is necessary to maintain a kitchen, that they are much better off having the oral supplements.”

According to Kaiser Health News, “The ACA’s penalty of one percent recently doubled for hospitals whose number of readmitted patients, within 30 days, goes above the national average specifically for those conditions. Federal data estimates $227 million in fines will be levied by Medicare this year against 2,225 hospitals.

 

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