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Patients are readmitted within 30 days for a myriad of reasons, some of which include common health conditions such as CHF, septicemia, pneumonia, COPD and cardiac dysrhythmias. The patient is at risk as they move between the acute care setting to home or other locations. Multidisciplinary care teams, including patients and their families, hospital staff, and post-discharge providers and caregivers, can help reduce the risk of readmission through ongoing two-way communication.
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Improving care and improving health is essential to Missouri’s hospitals, health systems and clinicians. Missouri hospitals tracked performance data on eight readmissions metrics, including acute myocardial infarction, coronary artery bypass graft, congestive heart failure, chronic obstructive pulmonary disease, hip/knee, pneumonia and stroke readmissions.
Risk adjustment for patient-level clinical acuity and basic demographic factors, such as age and gender, are commonplace. However, a growing body of research is emerging around individual- and community-level social factors associated with hospital readmission risk. MHA’s Focus on Hospitals website reports readmission rates for participating hospitals that are adjusted for patients’ sociodemographic status. Specifically, the models include Medicaid status and the poverty rate of a patient’s home census tract.
To encourage efforts to reduce readmissions, Congress created the Hospital Readmissions Reduction Program as part of the Affordable Care Act in 2010. Through the ACA, CMS is instructed to penalize hospitals with higher than expected readmissions for specific clinical conditions such as AMI, pneumonia and heart failure. In FFY 2015, chronic obstructive pulmonary disease and hip and knee replacements were added to the list of clinical conditions. The HRRP payment penalties took effect in FFY 2013, and hospitals can now incur a penalty of up to 3 percent of their base operating Medicare diagnosis-related group payments — the maximum penalty defined by the ACA.
Preventing avoidable readmissions is an important component of hospitals’ ongoing quality improvement efforts. Understanding the phenomena and intervening in the most effective manner is essential to success in national efforts to improve patient outcomes and curtail health care spending. Recent clinical research, value-based purchasing policies and transparency initiatives from CMS have focused a growing amount of attention and resource allocation aimed at curbing expensive hospital inpatient readmissions.
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