The Remington Report has just published some statistics on the problems we as a society face in trying to manage health care costs. The challenges in doing so are huge, and it is going to take real change, real innovation, in order to turn things around. Whether CMS (Center for Medicare and Medicaid Services) will push for that change – or even accept the pushing those of us in the industry are doing – is an unanswered question. What we do know is the statistics are pretty stark:
- Average health care costs for folks over the age of 65 is about $12,000 each year
- There are currently almost 10 million seniors who are eligible for both Medicare and Medicaid (referred to as dual eligibles)
- This group constitutes 16% of Medicare enrollees, but 27% of Medicare costs
- This group constitutes 15% of Medicaid enrollees, but 39% of Medicaid costs
- 20% of Medicare patients who are hospitalized are re-admitted to the hospital within 30 days, costing more than $26,000,000,000
- 56% of all re-admissions involve patients not receiving post-acute care
All of these stats are vitally important, but re-admissions are a particular target of CMS. Preventing those 30-day re-admissions would save an incredible amount of money. So why do we see the last number?! 56% of all re-admissions are not receiving post-acute care. They just go home, ignore their medications, diets, exercise program, other medical advice – or are unable to conform, for medical reasons – and end up right back in the hospital.
This problem is one we have been talking to the medical community and CMS about for a number of years. Getting home care for folks being discharged from hospitals and rehabilitation facilities is an absolutely sure-fire way to cut those bad statistics dramatically.
Integrated teams, comprising hospital and other clinical staff, including home health, as well as non-clinical home care, from agencies such as the members of the Home Care Association of America, must be formed to work together. By providing that badly needed post-acute and even long-term care, the financial costs of health care can be lowered and the quality of patient outcomes can be dramatically improved.
Best wishes. Bert