Caregiver Act aims to reduce hospital readmissions

When Brenda Love of Wichita worked as a hospital emergency-room nurse, she often treated patients who had just gotten out of the hospital and were on their way back in – especially seniors.

The reasons varied: Sometimes they couldn’t cook and got malnourished, or they couldn’t get to their doctor’s office or pharmacy for follow-up, she said.

Others contracted infections because they didn’t change dressings properly, or were unable to navigate in a wheelchair and hurt themselves trying to do simple tasks like getting in and out of bed.

“I had one patient fall and rebreak her hip three times in one month,” Love said.

Experiences like that brought Love to the state Capitol last week as part of a group of seniors and supporters pressing for a bill requiring hospitals to interact more directly with caregivers when they discharge a patient.

The red-vested volunteers, members of the American Association of Retired Persons, met with numerous members of the Legislature and even buttonholed the governor in the Statehouse lobby to pitch for their bill.

Called the Caregiver Act, the bill would require hospitals to work with a patient’s caregiver, often a family member, to ensure that necessary preparations are in place for the patient to continue to recover at home after being discharged.

Some hospitals already do a good job of that, but others are inconsistent, said Maren Turner, state executive director of the AARP.

Too frequently, discharged patients have to return to hospital care because they injure themselves trying to do too much for themselves, or their caregiver doesn’t have a clear plan to follow for medication, nutrition and living needs in the home.

“It’s really important the caregiver is well informed on what to do so they (patients) don’t come back in a couple of days or the next week,” Turner said.

The bill dovetails with federal and state efforts to reduce government health care costs by reducing hospital readmissions among the poor and elderly.

The federal Affordable Care Act, passed in 2012, requires the Centers for Medicare and Medicaid Services to levy financial penalties against hospitals with excessive rates of preventable readmissions for government-subsidized patients.

Last year, 34 Kansas hospitals – more than a fourth of the hospitals in the state – paid penalties for excessive readmissions, according to research compiled by Kaiser Health News, a wing of the Kaiser Family Foundation.

Nationally, more than 2,600 hospitals were penalized last year.

In 2013, Medicare estimated that preventable readmissions cost the health care system $16 billion in unnecessary hospital bills.

But the rate is dropping.

From 2007 to 2011, the readmission rate for all causes was over 19 percent. It dropped to 18.5 percent in 2012 and 17.9 percent in 2013, according to the Medicare data.

That, according to the federal agency, represents a reduction of about 150,000 unnecessary hospital admissions a year.

Gov. Sam Brownback said he had not seen the language of the Caregiver Act, so he didn’t know if he would endorse it.

But he praised the idea, saying it parallels cost-reduction priorities within KanCare, the state’s privatized Medicaid health system.

“We’re trying to make sure people can take care of themselves so they don’t have to go back into the most expensive care,” he said.

He also said the AARP told him the bill would not require any state money.

“I like that,” he said.

The Caregiver Act has bipartisan support in the Legislature.

Rep. Connie O’Brien, R-Tonganoxie, introduced it in the House, and Sen. Oletha Faust-Goudeau, D-Wichita, said she’ll introduce it in the Senate.

O’Brien said the bill would let the patient or the patient’s legal guardian appoint a caregiver who would be given access to the discharge records.

Hospital staff would be required to provide the caregiver with instructions for follow-up treatments for ongoing recovery.

“We just want to make sure if there’s something they need or instructions on what they need to do, they get those instructions,” she said.

This story was originally published January 17, 2015 at 3:47 PM with the headline "Caregiver Act aims to reduce hospital readmissions."