California’s overall 30-day readmission rate has declined from 14% in 2011 to
13.5%
in 2015. The rate of unplanned hospital readmissions is an important measure of clinical quality. High rates may indicate concerns with low quality and are associated with high costs.
Are hospital readmissions costly?
The cost of hospital readmissions is enormous, estimated to be in the vicinity of $26 billion annually
(Wilson, 2019), so it’s no wonder Medicare is working to reduce this amount. According to the Advisory Board, “In FY 2019, 82% of hospitals in the program received readmissions penalties.
What is the 30-day readmission rule?
The HRRP 30-day risk standardized unplanned readmission measures include:
Unplanned readmissions that happen within 30 days of discharge from the index (i.e., initial) admission
. Patients who are readmitted to the same hospital, or another applicable acute care hospital for any reason.
How is readmission rate calculated?
The Observed Readmission Rate is the percentage of acute inpatient stays during the measurement year that were followed by an unplanned acute readmission for any diagnosis within 30 days. It is equal to
the Count of 30-Day Readmissions (Column 2) divided by the Count of Index Hospital Stays (Column 1)
.
Why are readmission rates bad?
For instance, in-hospital mortality has been found to be higher for patients who are readmitted versus those who are not. Other researchers argue that
readmissions lead to an increased length of stay and expenditure of more hospital resources
.
Why are hospital readmissions so costly?
Optimize transitions of care
Ineffective care transitions following a hospitalization
increase the rates and costs of hospital readmissions. Inadequate care coordination, such as lackluster care transition management, accounted for $25 to $45 billion in wasteful spending in 2011, Health Affairs reported.
Does Medicare pay for readmissions?
The Hospital Readmissions Reduction Program (HRRP) is a Medicare value-based purchasing program
that encourages hospitals to improve communication and care coordination to better engage patients and caregivers in discharge plans and, in turn, reduce avoidable readmissions.
What is the 30 day readmission rate?
Readmissions. Between 2010 and 2017, the rates of adjusted HF and all-cause 30-day readmissions increased from 8.11% to
8.7%
(P trend 0.04) and 18.3% to 19.9% (P trend <0.001), respectively (Figure 1).
How can I reduce my 30 day readmission?
- Ensure Adequate Nursing Coverage. …
- Improve Transitional Care. …
- Ensure Patients Understand Post-Discharge Instructions. …
- Schedule 7-Day Follow Up Appointments. …
- More Resources on Reducing Readmissions:
How much does a heart failure readmission cost?
Readmission Cost
[67] estimated the mean cost of care of readmission over a 30-day period after HF hospitalization in the same hospital at
$15,732 per patient
and in a different hospital at $25,879 per patient (the associated mean length of stay per patient was 6.1 and 7.5 days, respectively).
Why are readmissions bad for hospitals?
Readmissions that occur within the first few days after discharge may reflect
poor care coordination or inadequate recognition of post-discharge needs
, whereas readmissions four weeks later are more likely to be due to the underlying severity of a patient’s disease or events out of the control of the hospital.
How can hospital reduce readmission rates?
- 1) Understand Current Policy. …
- 2) Identify Patients at High Risk for Readmission. …
- 3) Utilize Medication Reconciliation. …
- 4) Prevent Healthcare-Acquired Infections. …
- 5) Optimize Utilization of Technology. …
- 6) Improve Handoff Communication.
Does Medicare pay for readmission within 30 days?
Medicare counts the readmission of patients who returned to a hospital within 30 days even if that hospital is not the one that originally treated them
. In those cases, the penalty is applied to the first hospital.
What is readmission healthcare?
A hospital readmission is
an episode when a patient who had been discharged from a hospital is admitted again within a specified time interval
. Readmission rates have increasingly been used as an outcome measure in health services research and as a quality benchmark for health systems.
What is plan all-cause readmission?
Plan All-Cause Readmissions (PCR)
Assesses the rate of adult acute inpatient and observation stays that were followed by an unplanned acute readmission for any diagnosis within 30 days after discharge among commercial (18 to 64), Medicaid (18 to 64) and Medicare (18 and older) health plan members.
Why is Hrrp bad?
Although HRRP was called an incentive program when it was implemented, it has not been seen as a positive incentive program. Instead, it is seen as a negative penalty program, because
hospitals are not rewarded for reducing their readmissions, but are penalized if they have higher than expected readmission rates
.
What is the leading cause of hospital readmissions?
| Medical Condition Cost (95% CI), $ | Sepsis 10,070 (10,021 – 10,119) | AMI 9424 (9279 – 9571) | Heart Failure 9051 (8990 – 9113) | COPD 9533 (9466 – 9600) |
|---|
What diagnosis has the highest 30 day readmission rate for Medicare patients?
Schizophrenia, alcohol-related disorders, and
congestive heart failure
were among the leading diagnoses with both the highest 7-day and 30-day readmission rates.
