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UMC Health System

UMC sees fewer Medicaid patients readmitted after adopting Cerner’s Readmission Prevention and Acute Case Management solutions

When University Medical Center (UMC) in Lubbock, Texas, turned to Cerner to lower the number of high-risk Medicaid readmissions, it found a couple solutions that made a big difference. After implementing Cerner’s Readmission Prevention and Acute Case Management solutions, the hospital saw a 34.6 percent drop in 30-day readmission rates among high-risk Medicaid patients from May through July of 2015.

“It has made a large impact in a short amount of time,” said Director of Case Management Christi Cargill, MSN, RN, ACM. “These solutions have improved communication and removed barriers.”

UMC — a 437-bed nonprofit academic hospital — worked with Texas Health and Human Services, which runs the state’s Medicaid program, on an initiative to identify patients at risk for readmission within 15 and 30 days of leaving the hospital.

The hospital recognized it had a problem with readmissions. That led to a decision to implement Cerner’s Readmission Prevention, fully integrated with Acute Case Management. At the same time, transition coaches worked with Medicaid patients to look for ways to keep patients at home and from returning to the hospital.

Before UMC adopted Cerner’s Readmission Prevention in May 2015, it’s 30-day readmission rate for high-risk Medicaid patients was 26.98 percent. By July, that fell to 17.64 percent. From September 2015 through August of 2016, the rate for patients readmitted within 15 days leveled off to 18.08 percent.

Switching to an integrated pair of solutions saved time for transition coaches who work with patients in an effort to try to keep them from returning to the hospital.

Cargill estimates it saved each coach two to three hours each day.

“Previous to these solutions, there was not a solid workflow for the transition coaches. The solution improved communication and removed barriers that have existed since 2010,” she said.

Readmission Prevention, along with Acute Case Management and embedded post-acute referrals, also makes it easier for workers to complete their paperwork electronically, instead of manual or with two-system workflows. From May to July 2015, UMC saw a 57 percent increase in completed discharge documentation for patients with a moderate to high risk of readmissions within 30 days.

Following UMC’s success, the health system plans to expand the program by offering the solution to more Medicaid coaches who focus on high-risk patients. In addition, it plans to offer the program to help manage its Medicare patients as well.

“It created transparency within our own department and will soon create a transparency organization-wide,” said Cargill.

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Client outcomes were achieved in respective settings and are not representative of benefits realized by all clients due to many variables, including solution scope, client capabilities and business and implementation models.