In this section, you’ll find:
• Ways to improve Star ratings
• Readmission prevention best practices
• Provider group case study
Following up with patients can improve rates for measures within both HEDIS and CAHPS domains. See “Details on how Stars are measured” section to learn more about these measures.
Top-five reasons readmission happens
Among Medicare Advantage patients, commonly cited reasons for acute readmission include:
1. Feeling unprepared for discharge.
2. Difficulty performing activities of daily living.
3. Trouble accessing discharge medications.
4. Struggling to adhere to discharge medications.
5. Lack of support from friends and family.
Communicate the importance of scheduling a post-discharge follow-up visit with a PCP.
Ensure that patients understand discharge instructions and that their medication list is reconciled.
Instruct patients how and when to access post-operative, emergency and urgent care, including after hours.
Engage with patients to understand their needs, such as family support, transportation, and in-home care.
Encourage patients to make the most of their Cigna Healthcare Medicare Advantage plan with suggestions, such as:
− Register or log in to myCigna.com for quick access to plan resources.
− Ask about transportation and meal home delivery benefits by calling 800.668.3813 (TTY 711) or 800.627.7534 (Arizona only).
− Switch prescriptions to home delivery pharmacy.
Provide contact information for support and resources.
There is a Star measure that assesses the percentage of acute inpatient or observation stay discharges that result in readmission for any reason within 30 days of discharge. Click here to learn more about the plan all-cause readmission (PCR) measure.