Oral nutritional supplements linked with decreased probability of 30-day hospital readmission

Fleishman-Hillard, Inc.Oct 19 2013

As Affordable Care Act penalties on hospital readmissions increase, nutritional intervention may help decrease 30-day readmission rates among Medicare patients

In the U.S., one in five Medicare patients is readmitted to a hospital each year at an estimated cost of $17.5 billion annually.i To reduce this impact, the Affordable Care Act (ACA) has introduced hospital penalties based on readmissions conditions that commonly affect patients aged 65 and older - including acute myocardial infarction, congestive heart failure and pneumonia.

A new study conducted by leading researchers at the University of Southern California, Stanford University, The Harris School at The University of Chicago and Precision Health Economics, and supported by Abbott, found that the use of oral nutritional supplements decreased the probability of 30-day hospital readmission, length of stay and costs among hospitalized Medicare patients aged 65 and over.

The study, to be presented this weekend at the 35th annual meeting of the Society for Medical Decision Making (SMDM) in Baltimore, demonstrated that oral nutritional supplements were associated with a decreased probability of 30-day readmission among Medicare patients aged 65 and over who could be tracked for readmission, with:

• 8.4 percent reduction for patients with any diagnosis
• 10.1 percent reduction for congestive heart failure patients
• 12.0 percent reduction for acute myocardial infarction patients

Oral nutritional supplements are dietary food, often in liquid form, that provide calories, protein and nutrients for added nutrition and energy in the diet.

Readmission Penalties

Starting this month, the ACA's current penalty of one percent doubles for hospitals whose number of readmitted patients, within 30 days, goes above the national average specifically for those conditions. Federal data estimates $227 million in fines will be levied by Medicare this year against 2,225 hospitals.

In addition, the Centers for Medicare & Medicaid Services is looking at expanding readmission penalties to include other diagnoses such as chronic obstructive pulmonary disease (COPD), and knee and hip replacements.

Length of Stay and Hospital Cost Reductions

In addition to readmission rates, the use of oral nutritional supplements also delivered associated improvements in a patient's length of stay and hospital costs. The study found the impact of oral nutritional supplements on length of stay and cost of care were even more impactful and statistically significant when looking at all Medicare patients aged 65 and older with any primary diagnosis:

• 16.0 percent or 1.65 days reduction in length of stay
• 15.8 percent or $3,079 in cost savings per episode

This impact is important because today hospitals are seeking interventions that improve patient care and reduce costs.

"Hospitals are going to be looking for ways to improve quality of care for Medicare patients in order to lower readmission rates and prevent fines," said study co-author, Tomas Philipson, Ph.D., who is the Daniel Levin Chair of Public Policy at the University of Chicago. "This analysis suggests that use of oral nutritional supplements is a simple and cost-effective solution that hospitals can implement immediately."

Through the analysis of 11 years of hospital data, researchers were able to determine differences in length of stay, episode cost and 30-day readmission rates for Medicare patients aged 65 and older by comparing cases where oral nutritional supplements were prescribed to patients with the same conditions to those who weren't prescribed oral nutritional supplements.

"Abbott is committed to delivering innovative nutritional solutions through products that improve the quality of care for patients and also help reduce healthcare costs," said Robert H. Miller, Ph.D., divisional vice president, Global Research & Development and Scientific Affairs for Abbott Nutrition. "This research aligns with other studies Abbott has conducted and on-going, and will contribute to the growing body of evidence that demonstrates the role nutritional supplements, such as Ensure-, can play in improving outcomes and lowering costs."