Hear from health and nutrition experts on how the Global Malnutrition Composite Score (GMCS) can help take your malnutrition program to the next level by improving patient outcomes and reimbursements. New reporting period begins January 1, 2024. Is your team ready?
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This video is part of Compass One Healthcare x HealthTrust Podcast Series.
Q: Malnutrition is a big topic in the world that we live. Why is it so important?
Peggy O’Neill: A little known fact is that about 30 to 50% of all patients admitted into the hospital actually have some form of malnutrition. It starts when they're in the community. Their body is not feeling well or they have a certain lifestyle that makes them at risk for malnutrition. Then, by the time they're admitted, they generally have malnutrition already. So, it's a big concern for us in the health care setting.
Q: It sounds like there's a lot of opportunities to tackle malnutrition and handle it in the workplace. Let’s talk about that a little.
Maureen Janowski: There are two new initiatives that we've really been working on when it comes to malnutrition. One of them is the Global Malnutrition Composites Board. CMS, the Centers for Medicaid and Medicare Services, just recently chose a nutrition related quality metric. Every hospital has to select three voluntary quality metrics, and nutrition now is one of them. As a Global Malnutrition Composite Score, the value of this is it's really showing us that CMS is saying malnutrition is important. We need to identify these patients so we can start treating them. That's a really nice benefit for us to encourage at the hospital to move forward with focusing on identifying malnutrition because now CMS is saying the same thing.
Q: What is the protocol to diagnose someone with malnutrition?
Maureen Janowski: As soon as somebody is identified as at risk for malnutrition, the dietician steps in. They do a nutrition assessment and then start the care plan. So, one of the big things that we work on is making sure we're identifying the right patients, because if the screening process isn't working right, then our dieticians are seeing the wrong patients. We need to start from the screening process and making sure we're using a validated screening tool. That the dieticians are seeing the right process, the right patients. Then they can start on the interventions. The second piece is the Post-Discharge. It's really difficult to cure malnutrition during a short hospital stay. We're working on a new discharge planning toolkit that educates our dieticians. You have to look beyond the hospitals. We have to make sure that our plan of care looks at what else can we do to help them after they leave.
Peggy O’Neill: They're already coming in malnourished, so we're sending them back after four or five days in a hospital. They're going right back to that setting where they became malnourished first place. So, we really have to work collaboratively with our medical support team to say ‘what are we doing different for this patient when they go home?’ Our discharge planning is as a very instrumental part of that.
Q: Is it fair to say that education around food is a big part of this, because patients probably don't even know that they are malnourished?
Peggy O’Neill: I'd say yes, but it's also their environment. Do they have access to food? Do they have access to transportation? Are there family members in charge of food or feeding them? What role does the family have in support? The patient, who is now going home, perhaps doesn't have access to food or more specifically healthy food, so they end up back in a hospital. There's a strong correlation between what they're doing at home and how often they come back to that hospital.
Q: How do better outcomes and cost reduction apply to malnutrition?
Maureen Janowski: Better patient outcomes start with identifying the patient sooner. As soon as we can identify them, the dietician sees them, then they start interventions. Malnourished patients are more likely to fall in the hospital and to get infections when they're in the hospital. So, the sooner we can intervene, the less likely they are to have some of those complications. We're looking to reduce their length of stay and then also to decrease their readmissions, which obviously impacts patient outcomes. It has a really nice side effect for cost avoidance in the hospital setting. They don't have to spend as much money on the length of stay and they have fewer readmissions.
Q: Do you have any clients taking advantage of these opportunities?
Peggy O’Neill: We have a growing group of clients that are participating in our malnutrition program because it's not just the intervention but it's also the documentation. It's really tracking what we're doing for those patients or what their outcomes are. Our clients are loving it because they're having cost avoidance, they're having increased Medicare reimbursement and they have positive patient outcomes that are measurable and also have a cost metric assigned to it. It's a win-win. Our dieticians are already doing what they need to be doing. Our physicians are doing what they need to be doing. It's just this a little extra attention and making sure that whoever we have to see is being seen or the interventions are being done. And then we're tracking all these outcomes. Once our clients are on board, they really love it.
Q: What can hospitals do to better combat malnutrition going forward?
Maureen Janowski: One of the first things that we want them to do is to sign up with a Global Nutrition Composite Score to be one of their voluntary metrics. Another thing they can do is work with their clinical dieticians and work with us, because in 2019 we released a software care and a malnutrition program called My Malnutrition. By using this, we are identifying the right patients so the dieticians are seeing the right patients. As we use the program, the number of patients hospitals identify and treat is increasing.
Peggy O’Neill: Malnourished patients are more likely to stay longer. They're more likely to have complications. Identifying them early on, implementing treatment plans, measuring them and making sure that those good habits carry into the community. That's what our partnership brings to the table. Our nutrition team has a unique opportunity to showcase the value that we bring beyond a food service contract. This is part of the package.