Readmission Worries

Beginning this month, another piece of the Affordable Care Act (ACA) starts to impact the medical community.  Hospitals will be subject to a penalty for their rate of readmission under the Medicare program.  Take a look at this informative blog for a quick overview of what is happening.  The specifics of the program are not critically important to those in pharmaceutical marketing, but the concepts behind the program and how our industry could help should be considered.

First note the overall intention of the program makes a lot of sense.  Hospitals should be doing everything in their power to make sure those they release from their care do not need to come right back due to complications or other issues.  This is a significant problem that costs the system quite a bit of money.  It will be interesting to see whether the penalty results in an overall savings and improves the overall quality of care.  What is very interesting to me is the lack of understanding and preparation the hospital administrators have given the program.  Like so many of the things in the ACA, it seems health professionals think that if they ignore them they will just go away.

This seems like an ideal opportunity for the pharmaceutical industry to really shine.  Our drugs are the primary tools that hospitals can use to prevent readmissions.  Patients must pick up their medicines and take them faithfully if they are to provide the desired efficacy.  The industry has numerous tools to make sure this happens.  Patient education is a must.  Discharge coordinators constantly struggle to make sure those leaving the hospitals fully understand what the patient must do now that they are on their own.  Again, patient education is a strength of our industry and we should provide as much help as we can to the coordinators.  Coordination of care is another huge issue in that patients leaving the hospital must return to the care of their community physician. The industry, as experts in physician communication, could help assure programs are in place that help hospital physicians communicate more effectively with community physicians.  There are so many other possible ways the industry could better influence performance in the readmission area and prove we are true partners in healthcare delivery.

The healthcare environment is changing at a pace never before seen by our industry.  Those who fully understand what is being implemented and can craft ways to benefit from these changes can significantly increase the status of their products and their companies.  It is all about anticipation and preparation.  The ACA is just one of many changes that are taking place.  The entire hospital environment is being rattled by cost cutting moves.  Last week, compounding pharmacies came under intense scrutiny that could dramatically change that segment of the business.  Consolidation has changed the mail order world.  The OIG has announced their targets for investigation in 2013 which is usually a clear indicator of where change will happen.  The list could go on and on.

All of these trends should be viewed as opportunities for the industry.  Those that ignore or are ignorant about the changes will fall behind.  Those that have a keen interest in healthcare policy and build plans and tools with an eye on the future will leapfrog over their competition.  As a marketing professional it is incredibly important to keep up with what is happening with your customers.  You don’t want to be like the hospital executives who are trying to figure out the readmission penalty after it has been implemented.  You need to develop a personal strategy for staying current in order for you to remain relevant.

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