Hospital Readmissions

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Welcome to MedeAnalytics’ Hospital Readmissions Resource Center! This online educational resource is a complimentary service to the healthcare industry.

Hospital readmissions could be an indicator of poor care or missed opportunities to better coordinate care. According to a 2009 study, almost 20 percent of Medicare beneficiaries are readmitted to the hospital within 30 days after discharge. This costs Medicare $17.4 billion a year.

Viewing this as at least a partially preventable source of poor quality of care and excessive spending, section 3025 of the Patient Protection and Affordable Care Act (PPACA) mandated the creation of a Hospital Readmissions Reduction Program (HRRP).

The HRRP went through an extensive rulemaking process, with a proposed rule disseminated in April 2012 and a final rule published in August 2012.

Over 2,200 hospitals will be assessed a penalty ranging from 0.01 percent to 1.00 percent of their Medicare revenue in fiscal year 2013 for excess hospital readmissions for three conditions: acute myocardial infarction (heart attack), heart failure, and pneumonia. It is estimated that nationwide, the penalties assessed will total $280 million.

After fiscal year 2013, the penalty cap will rise to 2.00 percent in fiscal year 2014 and 3.00 percent in fiscal year 2015. In addition, per the PPACA, the Secretary of the Department of Health and Human Services is empowered to increase the number of conditions for which hospital readmissions will be assessed.

We invite you to visit this resource center often to keep abreast of the latest salient developments regarding hospital readmissions in general and the HRRP in particular.

“Hospital readmissions are receiving increasing attention as a largely correctable source of poor quality of care and excessive spending. According to a 2009 study, nearly 20% of Medicare beneficiaries are rehospitalized within 30 days after discharge, at an annual cost of billion.”

– Robert A. Berenson,et al., “Medicare’s Readmissions-Reduction Program—A Positive Alternative,” New England Journal of Medicine, April 12, 2012

“Reducing preventable readmissions will significantly affect the bottom line and quality scores of hospitals as Medicare and other payers apply readmission penalties and publish data related to hospital readmissions—and will improve value for payers, purchasers, and the communities an organization serves.”

– Mark Aspenson and Sunil Hazaray,“The clock is ticking on readmission penalties,” hfm, July 2012

“Readmission rates are important markers of quality of care, particularly of the care of a patient in transition from an acute care setting to a nonacute care setting. Successful efforts to reduce preventable readmission rates will improve quality of care while decreasing costs.”

– Healthcare Financial Management Association,“Hospital Readmissions Reduction Program Overview,” June 2012

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“Hospital readmissions are receiving increasing attention as a largely correctable source of poor quality of care and excessive spending. According to a 2009 study, nearly 20% of Medicare beneficiaries are rehospitalized within 30 days after discharge, at an annual cost of billion.”

“Readmission rates are important markers of quality of care, particularly of the care of a patient in transition from an acute care setting to a nonacute care setting. Successful efforts to reduce preventable readmission rates will improve quality of care while decreasing costs.”

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