Accountable Healthcare/Accountable Patients

My friend Mike Bearce, CEO of Fall Prevention Clinics, wrote this great blog about the changes that will take place for older adults and how some things will affect them. Falls are not sexy, but they can be devastating and need to be a topic in healthcare.

Under the Affordable Care Act, hospitals, skilled care and rehabilitation centers (they used to be called nursing homes!) are looking at reduced Medicare payments for patients that are discharged…and then readmitted within 30 days for the same or related problem.

Generally speaking, the majority of over-age-65 folks are readmitted because of: 1. Medication mismanagement…which means that the patient is not taking their prescription medicines according to the physician instruction…OR 2. Fall Injury…which usually occurs during the at-home recuperation or rehabilitation period, when no skilled personnel are there.

In order to keep their revenues up and patient readmissions down, the hospitals, skilled care and rehabilitation centers are working to improve their interactions with patients, before AND after discharge.

Plopping a patient in a wheelchair and delivering them to the curbside with a folder or bag full of pre-printed advertising, discharge instructions, and other non-specific information… is giving way to more personalized dialogue with private case managers who are charged with physician and patient follow-up in order to monitor progress and recommend interventions that may be needed.

These efforts are being implemented in various flavors across the country… and will undoubtedly be a work-in-progress for the foreseeable future. As Medicare and our medical facilities work to provide ever-improving patient care while containing and reducing costs… the patient also has a bigger role in their health. Here are a few things that ALL patients should do in order to get well and stay well:

1. Always have a spouse, family or friend on hand when speaking with physicians, social workers and case managers… since we commonly only remember half of what is said, two sets of ears is a good idea!

2. Before discharge from a hospital or other skilled facility, ask your social worker or case manager to write down what your next appointments and care steps are.

3. If you are to have home health, ask your social worker or case manager to set up meetings with representatives from more than one home health agency…BEFORE you are discharged!

4. Always ask questions! The more you know about your condition(s) and treatment, the more likely that you will have a good outcome… and avoid a relapse.

Keep moving!


Want more clever information about healthcare? Visit my site at

I have E-books and I am putting together tele-classes to help people learn how to advocate for their best healthcare. Be well!

Yours in health,

Tiffany Matthews, BSW, MJ a.k.a. Healthebooklady