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Reducing Hospital Readmissions: It’s Not Just About the Numbers


According to the Institute of Healthcare Improvement (IHI), hospitalizations account for nearly one-third of the total $2 trillion spent on healthcare in the United States, and a substantial portion of these are avoidable patient readmissions.

Government reforms such as The Affordable Care Act have been putting increased pressure on hospitals to reduce readmission rates or otherwise face penalties, forcing them to find new and improved ways to keep patients out of the hospital and in the comfort of their homes.

Generally, these reforms have resulted in a number of conversations focused around the implications and penalties of high readmission rates on hospitals, accountability issues, and quality measurement.

These are all important discussion points, but the important fact that is often overlooked is that patients can receive better care and avoid hospital doors due to these new incentives. This provision is not just important for a hospital’s bottom line and cutting health care costs – it’s important for the patients.

When a patient receives care at home they are taking part in true patient-centric care. The Institute of Medicine (IOM) defines “patient-centered care” as, “providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all decisions.”

Home care is not only an obvious solution for reducing readmissions, it’s an opportunity to improve patient outcomes and the overall quality of care. With that being the case, more and more hospitals are taking advantage of partnerships with home care providers to focus on transitioning patients into their homes—which is great news for home care providers and patients.

Take for example the recent partnership between AlayaCare, Southlake Regional Health Center (Hospital), CBI Health Group (Home Healthcare Provider), Professor Carolyn McGregor at the University of Ontario Institute of Technology (UOIT), and the Centre for Excellence in Economic Analysis. These organizations partnered together to seek new ways to reduce hospital admissions and emergency department visits for chronically ill patients.

They are one of five teams awarded up to $250,000 to improve patient outcomes and enhance patient experiences through the use of innovative technologies. The hope is to reduce hospital admissions for patients enrolled in the program by at least 50%, and demonstrate that a public-private partnership (PPP) between hospitals and private community care providers is an efficient service delivery model that can improve patient outcomes.

AlayaCare’s role within the project is to provide innovative technologies such as a Home Care App, RPM Dashboard, Family Portal, Digital Point of Care Documentation and Machine Learning algorithm-based clinical support tools, which allow for better coordination and quality of care across the healthcare continuum.


Managing readmissions might be a complex task, but thanks to these initiatives, hospitals are highlighting the important role of home care in keeping patients away from Emergency Departments and improving outcomes.