Reducing readmissions proactively

Incorporating house-call follow-up visits for certain clinical conditions will reduce costly, unreimbursable readmissions within 30 days of discharge. Some patients do not have a regular primary care physician or are unlikely to schedule a follow-up appointment due to health or transportation issues. The lack of follow-up care and inability to comply with post-hospitalization care often leads to re-hospitalization.

Amerimed MIH works proactively with hospital discharge coordinators to receive and implement plan of care. We focus on the needs of patients and their caregivers and understand the importance of responding quickly to new referrals.

In addition, we coordinate with the appropriate, office-based, physicians, utilize electronic medical records to document visits, update prescription drug records, physician orders, and any changes are sent to appropriate medical professionals.

Good follow-up care and patient compliance can reduce re-hospitalizations and ER visits. Additionally, critical bed space will be available for new (payment eligible) cases. Lower readmission rates also improve the hospital’s quality metrics as tracked by CMS, JCAHO, etc.