MedPAC: Readmission rates fell more than CMS reported

Hospitals may be preferentially targeting readmissions included in CMS penalties

New Medicare Payment Advisory Commission (MedPAC) analysis finds that 30-day hospital readmissions decreased by 0.7% from 2009 to 2011, significantly more than CMS reported earlier this year.

Kaiser Health News attributed the major difference between the two group's estimates to MedPAC's decision to exclude patients who returned to the hospital with a condition unrelated to their initial stay.

Using a methodology that included readmissions unrelated to the initial stay, CMS found that 30-day hospital readmissions for Medicare patients declined by just 0.2% from 2009 to 2011. When MedPAC estimated readmissions using a similar methodology, it found that readmissions fell by 0.3% over the same period.

The hospital industry has long urged CMS to adopt MedPAC's approach to readmissions.

Hospitals may target certain readmissions

Beginning on Oct. 1, CMS will penalize 2,211 hospitals for excess readmission rates for heart failure, pneumonia, and myocardial infarction patients between 2009 and 2011. MedPAC estimates that the hospitals will incur an average penalty of $125,000.

Preliminary MedPAC data suggest that readmissions rate for the three conditions scrutinized by CMS improved more than Hospital Compare estimates indicate, according to MedPAC analyst Craig Lisk. "There appears to be some evidence that hospitals are starting to preferentially reduce readmissions for these three conditions," he told the commission.

MedPAC analyst Jeffrey Stensland says that hospital efforts to reduce readmission rates show that "the penalty is serving its purpose of motivating hospitals to take action” (Rau, "Capsules," Kaiser Health News, 9/14).


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