Reducing unnecessary hospitalization

Rep. Adrian Smith

Aug 4, 2018

Caring for the elderly and disabled among us is one of our most sacred responsibilities. Many of us have family or friends living in skilled nursing facilities and we want them to have access to the best care available in the event of an emergency.

Unfortunately, this is not always the case. Despite the availability of new technologies and qualified medical professionals in nursing facilities, seniors and the disabled across our country are frequently transported to hospital emergency rooms to receive emergency care. In fact, around 19 percent of hospital transfers come from skilled nursing facilities and one in five of those discharged after treatment will have to return yet again for a follow-up visit.

This needs to change. I introduced the Reducing Unnecessary Senior Hospitalization Act to bring much-needed innovation to these facilities and the Medicare program as a whole. The RUSH Act would allow the use of technologies such as telehealth in skilled nursing facilities to treat patients in place rather than transferring them to the hospital.

Telehealth gives medical professionals and first responders like those already working in skilled nursing facilities access to doctors who can provide immediate consultation in emergency situations. The Centers for Medicare and Medicaid Services found that 45 percent of hospital admissions from these facilities could have been avoided with such an arrangement. This would not only save a great deal of money, but also prevent Medicare beneficiaries from being unnecessarily exposed to health risks such as falls, delirium, infections and adverse medication interactions.

At present, however, Medicare is unable to reimburse skilled nursing facilities for the cost of telehealth providers. The RUSH Act would address this problem by allowing Medicare to make arrangements with medical providers to allow acute care at skilled nursing facilities using a combination of telehealth and on-site first responders.

Treating patients in place with the aid of an emergency physician represents a three-way win: patients are not subjected to traumatic, rushed trips to the emergency room unless absolutely necessary, emergency rooms are less congested and thus enabled to more swiftly treat those in need, and the American taxpayer bears a lower cost to maintain the Medicare program.

This innovative, 21st century care model is long overdue. The RUSH Act would significantly decrease emergency room visits and improve quality of life at skilled nursing facilities across the country. I look forward to the implementation of this and many other great ideas which will improve the Medicare program and help us to keep our promises to seniors.