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Shaheen and Blumenauer: We Can Limit Rehospitalizations

Reaching agreement in Washington, D.C., can be difficult, but one thing we all agree on is that our health care system is broken and must be fixed. We need to cut health care costs while improving the quality of available care.

There are a lot of ideas regarding what we need to do to achieve this goal. Some are complex and will require much examination and debate, but others are straightforward, common-sense solutions that we can enact quickly to address some of our most costly health care problems. Our bipartisan Medicare Transitional Care Act is one of those common-sense fixes.

The goal of this legislation is simple. We want to reduce Medicare costs and offer better support and coordination of care to Medicare patients by keeping seniors who are discharged from the hospital from unnecessarily returning. This bill will improve the quality of the health care we offer our seniors while saving taxpayer money.

According to a recent report in the New England Journal of Medicine, nearly one-third of Medicare beneficiaries discharged from the hospital were rehospitalized within 90 days. One-half of the individuals rehospitalized had not seen a physician since they left the hospital, which puts patients at risk and increases the likelihood of their ending up back in the emergency room. 

This doesn’t just affect Medicare beneficiaries and their families — rehospitalization is extremely expensive. The same study estimated that in 2004, Medicare spent $17.4 billion on unplanned rehospitalizations. This problem is costly for our government and troublesome for our seniors, but the good news is that this problem is avoidable.

Research shows that the transition from the hospital to the patient’s next place of care — be it home, or a nursing facility or rehabilitation center — can be complicated and risky. This is especially true for older individuals suffering from chronic illnesses. These patients admit difficulty remembering instructions, confusion over correct use of medications and general uncertainty about their conditions. It is clear that patients need support and assistance to manage their health needs along with their caregivers, and this legislation provides that opportunity.

Take the example of Lena from Texas. Lena had been experiencing reoccurring shortness of breath and was hospitalized every six weeks for more than a year. She would be admitted, treated and then released — only to return for another expensive hospital visit with the same problems. Fortunately for Lena, someone finally stepped in and identified the early warning signs of congestive heart failure. Lena was taught how to live with and manage her condition and lived another two years without a single visit to the hospital. This is a perfect example of simple steps that can be taken to prevent unnecessary hospital visits and address symptoms within the home, rather than the emergency room.

Under the Medicare Transitional Care Act, a transitional care clinician would help ensure that Lena and people in similar circumstances are provided appropriate follow-up care during the vulnerable period after being discharged from a hospital. 

This easy-to-implement and cost-saving benefit would be phased in and provided first to the most at-risk individuals. And it will be tailored to meet each individual’s needs. This may be as simple as making sure each patient understands how and when to take their medication or helping them make sure they schedule and are able to get to follow-up appointments with doctors. It may be helping patients and caregivers coordinate support services, such as medical equipment, meal delivery, transportation or assistance with other daily activities.

Proper transitional care is important not only to reduce hospital readmissions, but also to improve patient outcomes and satisfaction. We need to pass this bipartisan legislation — co-sponsored by Sen. Susan Collins (R-Maine) and Rep. Charles Boustany (R-La.) — to fix this problem. Doing so will save taxpayer dollars while improving quality of care and quality of life for our nation’s seniors.

Sen. Jeanne Shaheen (D-N.H.) and Rep. Earl Blumenauer (D-Ore.) are the prime sponsors of the Medicare Transitional Care Act.