Released: The Dartmouth Institute’s Report for Opportunities Related to Hospital Acquired Conditions and Readmission Rates

Unless hospitals curtail the trend of  “excessive numbers of patients returning shortly after they are discharged,” hospitals could face the Medicare penalties for high readmission rates that take effect in October 2012. (U.S. Hospitals, Facing New Medicare Penalties, Show Wide Room for Improvement at Reducing Readmission Rates, p. 1 (Sept. 28, 2011)). The Dartmouth Report analyzed all 10.7 million Medicare patient hospital discharges between July 2003 and June 2009, and found little variation.

While surgery patients were the least likely to be readmitted (12.7% re-hospitalized in 30-days), congestive heart failure, pneumonia, hip fractures and other conditions showed significant room for improvement. (Kevin O’Reilly, Hospitals Make Almost No Headway in Cutting Readmissions, amednews.com (Oct. 10, 2011)). Variations in re-admission rates were noted between regions. Following-up with a primary care physician, inadequate discharge planning and lack of care coordination were just a few of the causes sited.

Faced with the prospect of Medicare pay being cut up to 1% in 2012 for readmission rates for heart attack, heart failure or pneumonia that are higher-than-expected for the 30-day period, providers need to assess their clinical documentation and care plans now. Otherwise, the penalty will only increase in October 2014 to 3%. (Ibid.)

Posted on:          under: Uncategorized