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The U.S. has one of the highest hospital readmission rates in the world. About 20 percent of Medicare patients wind up being readmitted within 30 days after discharge. Hospitals have tried a variety of strategies, including patient counseling and home visits to lower readmissions, with mixed results. The office that administers Medicare is hoping that new financial penalties, part of the Affordable Care Act, will push hospitals to tackle the problem more aggressively.
The reasons behind hospital readmissions are complicated and varied. But experts have argued that hospitals could go a long way toward reducing readmissions by ensuring that patients receive proper follow-up care after discharge. To this end, some hospitals are partnering with retail clinics, such as Walgreens's Take Care Clinic and CVS's MinuteClinic. These clinics have medical staff and pharmacies on site, along with flexible hours, and typically do not require appointments. “This brings us out into the community in a way I think could be really beneficial,” says David Feinberg, president of the University of California, Los Angeles, Health System, which last summer began a partnership with 11 CVS clinics. So far data on the success of the partnership are only anecdotal, but he and his colleagues are so satisfied with the results they are expanding the program.
Some clinicians have expressed concerns that the standard of care might be lower at retail clinics, which tend to be staffed by nurse practitioners instead of doctors. The current data, however, suggest that the clinic patients are receiving quality care, says Ateev Mehrotra, a policy analyst at Rand Corporation and the University of Pittsburgh.