September 14, 2016
According to recent data released by the Centers for Medicare and Medicaid Services (CMS), almost all of the United States and Washington DC, excluding Vermont, have reduced avoidable hospitals readmission rates since 2010 following
“Potentially avoidable hospital readmissions that occur within 30 days of a patient’s initial discharge are estimated to account for more than $17 billion in Medicare expenditures annually,” Patrick Conway, MD, principal deputy administrator and chief medical officer at CMS, said in a CMS Blog post. “Not only are readmissions costly, but they are often a sign of poor quality care.”
This widespread decrease in the amount of avoidable hospital readmissions comes in the wake of the implementation of various CMS programs and initiatives, such as the Affordable Care Act’s (ACA) Hospital Readmissions Reductions Program.
According to the CMS Blog post, hospital readmissions can generally be avoided through improved care practices, including discharging patients with appropriate medications, follow-up care instructions, and follow-up appointments to ensure treatment adherence. The ACA’s Hospital Readmissions Reduction Program adjusts payments for hospitals with higher than expected 30-day readmission rates for targeted clinical conditions, including heart attacks, heart failure, and pneumonia. Furthermore, CMS has also launched the Partnership for Patients program, which aims to make hospital care safer and improve overall quality of care for patients as they transfer health care settings.
Surgery at High-Quality Hospitals Less Expensive for Medicare
CMS Reveals 2017 Program Allowing MACRA Participation Flexibility
The data showed that Medicare beneficiaries avoided approximately 100,000 readmissions in 2015 alone, compared to approximately 565,000 readmissions since 2010. The overall readmission rate in 43 states fell by more than 5%, and in 11 states readmission rates fell by more than 10%.
However, data showed that the 30-day hospital readmission in Vermont increased slightly over the study period, from 15.3% in 2010 to 15.4% in 2015.
“The Hospital Readmissions Reduction Program is just one part of the Administration’s broader strategy to reform the health care system by paying providers for what works, unlocking health care data, and finding new ways to coordinate and integrate care to improve quality,” Conway said in the blog post.
Additional initiatives including use of accountable care organizations, as well as efforts by quality improvement organizations and hospitals engagement networks are also in place to help lower hospital readmissions and improve patient care.
According to the CMS blog post, “The goal of all of these efforts is to spend our health care dollars more wisely to promote better care for Medicare beneficiaries and other Americans across the country.” —Julie Gould