CMS: Affordable Care Act Contributing to Decline in Hospital Readmissions
The rate of hospital readmissions within 30 days of discharge for Medicare beneficiaries declined to 17.8% in November 2012, from a 19% annual rate over the previous five years, according to CMS figures released Thursday at a Senate Finance Committee hearing, the Washington Post reports.
About the Findings
Although the data do not pinpoint a cause for the drop, CMS officials attributed the decline to provisions in the Affordable Care Act that penalize high readmission rates and fund efforts to reduce readmission rates.
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, Premier Healthcare Alliance, has reduced its average 30-day readmission rate among its 450 hospitals from 11.2% in 2010 to 10.2% in September 2012.
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.
CMS Official Says Data Represent a 'Fundamental, Structural Change'
The Obama administration hopes that reducing readmission rates can be a significant tool to curb Medicare spending, the Post reports.
Jonathan Blum, director of the Center of Medicare at the Centers for Medicare and Medicaid Services, said "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. â¦ I believe what we are seeing is a fundamental, structural change" (Aizenman, Washington Post, 2/27).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.