Alana drives down readmissions

NASHVILLE, Tenn. - A year into a high-touch disease management program, Alana Healthcare has reduced readmission rates for stage IV COPD patients with respiratory failure between 40% and 73%.

Alana's Comprehensive Respiratory Outcome Management (CROM) seeks to reduce hospital readmissions among COPD patients by educating them about their disease and helping them learn to manage it. Upon discharge, a respiratory therapist (RT) performs an in-home assessment and, in conjunction with the physician, tailors a program to that patient, says President Justin Schneider.

“We look at their whole lifestyle,” he said. “We examine their homes, what are their surroundings, what is their nutrition plan?”

Alana currently serves several hundred patients through CROM.

A key tenet of the program includes mutual accountability, says Zach Gantt, who helped develop CROM.

“We are going to do a better job if the patient understands and they want to be involved, rather than if they are just listening to somebody telling them what to do,” said Gantt, vice president of health management services. “They understand why they are supposed to eat healthy, why they should exercise, and how to attain those goals.”

To root patients on, RTs typically make many home visits during the first month. There is also a 24/7 help line patients can call.

“The RTs become part of their life and they have a vested interest to get these patients better,” said Schneider.

The provider has also begun implementing CROM in skilled-nursing facilities, with its RTs setting up “CROM units” within the facilities. It's a way to bridge the gap for transitional care between the hospital and the home.

“What we discovered was, due to the lack of awareness of transitional care, patient needs are not always met,” said Keisha Harper, director of transitional care for Alana. “They are more high-cost patients because they keep coming back into the hospital.”

While the provider has always had a strong respiratory program, the implementation of the Affordable Care Act (ACA) was a driving force behind CROM, says Schneider.

“It went to the heart of what the ACA was about, which was get out there and try to develop programs that prevent people from being put in the hospital, prevent their diseases from getting worse,” he said. “It's about being proactive participant in the healthcare chain.”