Clinicians who have gotten attached to patients being discharged shouldn't get too choked up-there's a good chance they'll be seeing them again, and soon.
Providers have been aware of problems with patient readmissions, but what was once a back-burner priority has suddenly grown into a looming dilemma, thanks to the move by Medicare to start penalizing hospitals that consistently show high rates of readmissions. And information technology plays a huge role in efforts to reduce readmissions, but providers are struggling to determine where I.T. will have the biggest impact in the process of extending the care continuum in a hybrid paper/electronic environment.
In federal fiscal year 2013, which begins in October, the Centers for Medicare and Medicaid Services will penalize hospital with high readmission rates-readmits within 30 days of initial discharge-the equivalent of 1 percent of their total Medicare billings, with the penalty rising to 2 percent in fiscal year 2014 and 3 percent in 2015. The program will focus on readmission rates for three common conditions-congestive heart failure, pneumonia and acute myocardial infarction (heart attacks). CMS was authorized to roll out the penalties through the hospital readmission reduction program tucked into the massive Affordable Care Act. It also has shined a light on readmission rates by publishing hospitals' 30-day readmission data for heart failure, pneumonia and heart attacks on its Hospital Compare Web site.
The Dartmouth Atlas Project, which for 20 years has used Medicare data to document variations in how medical resources care consumed in the United States, found that overall, 16.1 percent of hospital patients were readmitted within 30 days of initial discharge. That rate, despite the billions of dollars poured into clinical systems over the years, has actually increased slightly in recent years-the readmission rate in 2004 was 15.9 percent, according to the project's research.
CMS estimates that costs associated with preventable readmissions exceed $17 billion annually. Another study by the Agency for Healthcare Research and Quality estimates that for Medicare patients aged 65 and older, about 19 percent of all hospital stays were readmissions within 30 days.
Health Data Management’s March cover story, “Can I.T. Keep the Patients Away?” examines the challenges of reducing readmissions and available tools to help keep chronic patients healthier. The story also is available in the monthly Digital Edition.
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