30-day Readmissions Reduction: An Imperative for Hospitals
Faced with potential reimbursement penalties starting this month, the need for hospitals to address reductions in 30-day preventable readmissions has become an economic, as well as a quality of patient care/outcomes, imperative.
The stakes are high. Cost estimates range between $17 billion to $31 billion annually, according to the Centers for Medicare and Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ) respectively, and hospitals are facing potential penalties of as much as 1% of their total Medicare billings for higher than permitted readmission rates.
Even though the readmissions problem has been studied extensively, and substantial investments in technology such as clinical systems have been made, the root causes are not well understood and the average 30-day readmission rate has remained fairly constant around 16% in the United States. While this lack of understanding may be attributed to variability in data from hospital to hospital as well as disease states, geography, demographic and socio-economic characteristics, progress has been made in identifying certain disease states more likely to result in readmissions as well as interventions that are positively impacting readmission rates.
There are a variety of prevention programs and interventions best practice hospitals have implemented that center around patient education, and pre-, and post-discharge coordination of care procedures. Even a simple follow-up call with patients positively impacts readmission rates.
A recent Strategic Solutions for the Readmissions Challenge provides an excellent overview of the key role proactive care and care transition best practices can play in reducing preventable readmissions. Featuring case studies from four leading health systems, the report provides valuable insights into various approaches used by these leading institutions to attack the readmissions challenge.