Medicare Patient 30-Day Readmission Rates Fell in 2012

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Healthcare executives across the country have been frustrated with their 30-day patient-readmission rates, especially among Medicare recipients. For five years or so, it seemed like nothing could be done to keep these rates from increasing.

However, 2012 might have been a turning point, according to CMS. As Stephanie Armour reports for Bloomberg, “Thirty-day readmission rates fell to 17.8 percent late last year after averaging 19 percent for the past five…The decline translates to 70,000 fewer readmissions in 2012 for Medicare, the U.S. health plan for the elderly and disabled.”

CMS deputy administrator Jonathan Blum believes this “shows the Affordable Care Act is working to rein in costs.” Furthermore, “healthcare spending is growing more slowly,” along with many healthcare organizations improving their quality scores.

This news should come as mild relief to the millions of C-suite executives who are dreading federal fines for high patient readmissions “under a provision of the healthcare system overhaul targeting $8 billion in Medicare cost savings within six years. Almost 1 in 5 Medicare patients hospitalized in the U.S. is readmitted within a month of their release, adding to hospital costs that jumped to $17.5 billion in 2010, according to the Medicare agency,” Armour writes.

Certain officials in the government recognize the challenge that lies before CMS and consequently, hospital executives. Senator Robert Casey (D-Penn.) acknowledged as much at the U.S. Senate Finance Committee before which Blum appeared. He told Blum, “This is very difficult to tackle, this issue that relates to delivering better care at a lower cost. It looks like you are beginning to unlock that door.”

According to Blum, adopting the ACO model of care is also helping hospitals in containing costs.

In fiscal year 2013, those hospitals that have high 30-day patient readmissions will lose up to 1 percent of Medicare reimbursements, while 2015 would bring 3-percent reductions, Armour reports. Medicare estimated last year that these “penalties may cost the industry $280 million this year,” with the average hospital paying $125,000 in fines.

How are you as executives dealing with readmission rates? What are some of the initiatives and programs that you’ve implemented? Have you seen a decline similar to CMS’s findings? What are some of the challenges involved in reducing readmissions?

For more on Blum’s perspective on patient readmissions, please see this article from HealthLeaders Media.

-by Pete Fernbaugh

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