New CMS figures show that the national rate of 30-day readmissions for Medicare patients dropped to 17.8% in November 2012 after spending years stuck at 19%—and White House officials say the Affordable Care Act deserves the credit.
Although the data released this week at a Senate Finance Committee hearing do not pinpoint a cause for the decline, Jonathan Blum of CMS argues that the drop "is largely the result" of the health law's provisions, such as penalties for high readmission rates and funding for new efforts to reduce readmission rates, the Washington Post reports.
For example, the ACA has funded an initiative that created 26 "hospital engagement networks," designed to work with more than 3,700 hospitals to better coordinate patient care. The largest of the HENs has reduced its average 30-day readmission rate among its 450 hospitals from 11.2% in 2010 to 10.2% in September 2012. Federal officials previously have touted what HENs already are doing to cut readmissions and infections.
Meanwhile, Medicare in October 2012 began penalizing 2,217 hospitals that had high readmission rates, and imposed the maximum fine of a 1% reduction in Medicare reimbursements on 300 of those hospitals through 2013.
In response, one hospital—Ridgewell Medical Center, a 109-bed hospital system in Waconia, Minn.—created a team to reduce readmission rates, developed a checklist to detail the condition of patients prior to discharge, and started to send paramedics to visit patients within 72 hours of discharge. Ridgewell's rate of preventable readmissions significantly decreased, although the overall rate increased from 7.6% to 8.4%, according to the Post.
The Obama administration hopes that reducing readmission rates can be a significant tool to curb Medicare spending, the Post reports.
According to Blum, "What I think is exciting is that a couple years ago the general reaction to these policies was that it was impossible to reduce hospital readmissions," but "what this data shows me is that it is possible. … I believe what we are seeing is a fundamental, structural change" (Aizenman, Washington Post, 2/27).