“Across states, Medicare beneficiaries avoided nearly 104,000 readmissions in 2015 alone, compared to if readmission rates had stayed constant at 2010 levels”, wrote Patrick Conway, principal deputy administrator and chief medical officer, CMS, in a recent blog post.
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Patients and hospital leaders have something in common: Neither want a readmission within 30 days of being discharged.
Daniel Brotman, MD, a professor medicine at Johns Hopkins University School of Medicine, examined three years of publicly available CMS data and looked at the hospital-wide readmission rates of almost 4,500 acute care facilities.
Since 2010, all states but one – Vermont – have seen Medicare 30-day readmission rates fall; in 43 states, readmission rates fell by more than 5 percent; and in 11 states, readmission rates fell by more than 10 percent.
The federal government says 3,161 Medicare patients avoided a readmission in Florida past year, which is a small number. but nationally it was 104,000 Medicare patients.
In 2014, more than 2600 hospitals handed over up to 3 percent of their Medicare reimbursements after exceeding the 30-day readmissions threshold, totaling approximately $428 million in fines. Florida’s readmission rate was 2.7 percent lower previous year than it was in 2010, while nationwide the reduction averaged 8 percent.
One early concern was that hospitals might try to improve their readmission rate by holding return patients for so-called “observational stays” without formally admitting them.
“Our hospitals recognize that it can be hard to make progress on these types of measures when your state is already a strong performer, but they are focused on continuing to reduce readmissions even further by improving the way we coordinate and integrate care”, Tieman said.
The Medicare data from 2010 to 2015 shows Florida hospitals are making incremental gains, Bruce Rueben, president of the FHA, said in a statement.
Florida hospitals’ average reduction was less than most, according to the report from the Centers for Medicare and Medicaid Services. Arizona, Delaware, Illinois, Maryland, New York, Ohio, Oklahoma, Rhode Island, and South Dakota join them on the list of states that have reduced more than ten percent of their preventable readmissions. But that may be due to the relative difficulty of lowering an already low rate.
Cumulatively, an estimated 565,000 Medicare seniors avoided rehospitalization from 2010 through 2015 because of quality improvements, CMS said. This work was the precursor to NJHA’s ongoing Partnership for Patients effort.
CMS noted that the majority of readmissions could be prevented through quality improvement activities, such as ensuring patients leave the hospital with the right medications, providing instructions for follow-up care, and scheduling follow-up appointments to monitor recovery. They also may not have family or friends to help them recover.
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“The goal of all of these efforts is to spend our healthcare dollars more wisely to promote better care for Medicare beneficiaries and other Americans across the country”, Conway wrote. Vermont’s data was “virtually unchanged”, Conway noted.
