Medicare readmissions fell by 70,000 in 2012

Large hospitals reported higher readmission rates, report reveals

A new CMS study finds that U.S. hospitals had 70,000 fewer Medicare readmissions than expected in 2012, but the cause of the decline remains unclear.  

For the study, researchers analyzed national Medicare readmissions data from 2007 to 2012. They found that the percentage of Medicare beneficiaries who were readmitted within 30 days of discharge remained "remarkably stable" at 19% from 2007 to 2011. However, the national readmission rate declined to 18.4% in 2012, which translated to a drop of about 70,000 readmissions.

Although the study found wide variations in readmission rates among regions, larger hospitals across the country typically had higher rates.

How will the findings affect the Readmissions Reductions Program?

In October 2012, CMS implemented the Hospital Readmissions Reductions Program, which allows CMS to withhold up to 1% of regular reimbursements for hospitals that have too many 30-day readmissions for heart attack, heart failure, and pneumonia patients.

The findings likely will encourage hospital executives and lawmakers who have attempted to reduce readmissions through financial incentives and efforts to improve post-discharge care and coordination, Modern Healthcare reports.

Health policy experts: More analysis is needed

Weill Cornell Medical College professor Matthew Press says that the findings are "exciting" but "closer monitoring and analysis needs to happen to figure out how and why these readmissions were averted."

Moreover, it remains unclear how Medicare beneficiaries recorded as outpatients under observation—which falls under Medicare Part B—are accounted for in readmissions data because such data only includes instances in which a person is admitted for Medicare Part A hospitalization services, according to Modern Healthcare.

Harvard School of Public Health professor Ashish Jha told Modern Healthcare, "The question to me is, have we really done a good job of preventing readmissions, or have we just reassigned people who would have been readmitted to a different status?" (Carlson, Modern Healthcare, 5/30 [subscription required]).

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