Reducing unnecessary hospital readmission rates is often cited as one of the more obvious solutions to tackling the problem of high U.S. health care costs. However, to effectively do so, the health care system needs to reward collaboration between all entities involved finds a report by the Northeast Business Group on Health (NEBGH). Currently, the system mostly just singles out one entity, hospitals, for penalties.

A coalition of 200 Northeast U.S. employers, providers, insurers and other stakeholders make up the NEBGH, and it pulled together 67 executives from employer organizations, health plans, hospital systems, suppliers and other stakeholders for this report on the opportunities and barriers to reducing hospital readmissions.

According to the report “Reducing Hospital Readmissions through Stakeholder Collaboration,” in the Northeast U.S., there is a need for hospitals, providers and health plans to do a better job of sharing timely data and taking a coordinated approach to care management encompassing pre-admissions and post-discharge care. Currently, hospitals, providers and health plans in the region each have access to information that helps them spot patients at high risk for readmission after an in-patient stay. However, they lack the systems to share that data and have little business need to do so.

The lack of a workable business plan that creates an incentive for all parties to support the need to better identify patients at high risk for readmissions, engage patients through education and communications, and establish a mutually accountable environment, is a barrier to doing more to reduce costly unnecessary readmissions, the report finds.

“To really move the needle on readmissions reduction, stakeholders need to pool their resources and engage in pre-planned management activities that would better identify patients at high risk for readmissions and lead to more efficient use of clinical support resources from both health plans and health systems,” said Jeremy Nobel, MD, MPH, Executive Director of the Solutions Center, NEBGH’s platform for identifying solutions to healthcare issues of critical importance to employers, in a statement.

Barriers to readmission avoidance and better care coordination identified by the report included:

• Uncertainty about ROI for current initiatives.
• Financial limitations to proactive resource deployment.
• Limited consensus-building capability between entities unaccustomed to collaboration
• Lack of standard data collection
• Lack of reimbursement for many types of post-discharge care coordination and follow-up services

Financial support for the NEBGH report and its related activities was provided by AstraZeneca, Boehringer-Ingelheim and Novo Nordisk.