Access can prevent some readmissions
Occasionally, a patient’s name on the admission sheet jumps out at Linaka Kain, disability examiner/Medicaid specialist at Trinity Rock Island (IL) campus, because she’s seen it many times in a short amount of time.
“If the patient has been here 10 times in a month, that is a red flag, and we need to figure out what is going on,” she says. Sometimes, a patient tells Kain, “You discharged me too early, and I got sick again,” and she discovers that the patient is being readmitted so often due to non-compliance with their medications or treatment plan.
If this is happening because of lack of coverage, she says, “now is the time to get the patient on a program. A lot of people think, ‘They’ll just deny me.’ I tell them, ‘If someone is helping you that knows the process, you are more likely to get approved.’”
Some patients don’t realize what they will need to go through after discharge, such as filling medications or obtaining follow-up care. “We can assist them with a week or two of vouchers for prescriptions. But if they don’t continue that, they will end up right back in the hospital,” says Kain.
Kain informs patients about a clinic they can go to at no cost if they are employed, which is staffed by volunteer nurses and physicians helping to provide care for employed persons without insurance. “The clinic can assist them in signing up for patient assistance through the drug companies and can help them establish a primary care physician if they don’t have one already,” she says.
Once patients have coverage, they often become more compliant with their treatment plan and stop getting readmitted so often, according to Kain. “They switch their way of thinking,” she says. “In some cases, they don’t use the ER as often. They have coverage, so they start going to the doctor instead.”