Readmission rates for patients covered by Medicare declined in all but one state during the five years leading up to the end of 2015, according to a recent report released by the Centers for Medicare and Medicaid Services (CMS).
CMS believes this drop in readmission numbers is linked in part to penalties imposed on hospitals as part of the Affordable Care Act (ACA).
“The national hospital readmission has been declining since 2012,” Brittney Manchester, a spokesperson for the Department of Health and Human Services (HHS), recently told Patient Daily.
HHS leadership believes the “strong financial incentives” in the Hospital Readmissions Reduction Program (HRRP) contributed to the drop.
“Public reporting of readmission rates on Hospital Compare -- and efforts of the Partnership for Patients program and the QIN/QIOs in working with providers to reduce readmissions -- have all contributed to the declining trend in the national readmission rate since passage of the Affordable Care Act,” Manchester said.
According to the CMS, nearly all states cut preventable hospital readmissions between 2010 and 2015. Additionally, almost a dozen states reduced avoidable readmission rates by more than 10 percent. Vermont is the only state that saw an increase in its readmission rate: by 0.7 percent over the five-year period, or 22 additional admissions.
Medicare reimbursements will be reduced for 2,597 hospitals due to readmission penalties in fiscal year 2017, according to a linked CMS report.
The CMS under HRRP will withhold $528 million in payments over the next year, an all-time high and increase of about $108 million from 2016, according to a Kaiser Health News analysis of the data released by CMS.
Prior to 2012, the all-cause 30-day hospital readmission rate among Medicare fee-for-service beneficiaries held steady from 2007 to 2011, with between 19 and 19.5 percent of beneficiaries readmitted within 30 days, the HHS told Patient Daily.
This rate fell to 18.5 percent in 2012. The all-cause 30-day hospital readmission rate among Medicare fee-for-service beneficiaries fell further to approximately 17.5 percent in 2013, translating into an estimated 150,000 fewer hospital readmissions between January 2012 and December 2013.
In a recently published study, researchers at Johns Hopkins University looked into data from the CMS showing readmission and mortality rates for nearly 4,500 hospitals over a three-year period.
The teams, led by Dr. Daniel Brotman, looked at data for patients who had suffered a heart attack, stroke, heart failure, chronic obstructive pulmonary disease or coronary artery bypass, according to a report by McKnights, a magazine for health care professionals.
Results showed that hospitals with the highest readmission rates were more likely to keep patients with heart failure, COPD or stroke alive. Such patients saw slightly higher chances of survival at hospitals with high readmission rates compared to those with lower rates.
“Using readmission rates as a measure of hospital quality is inherently problematic,” Brotman told McKnights. “High readmission rates could stem from the legitimate need to care for chronically ill patients in high-intensity settings.”
While some high readmission rates may be due to complications or unsuccessful care transitions, they may also be driven by frail or seriously ill patients, Brotman said.
Data on readmission rates cover patients suffering chronic lung disease, coronary artery bypass graft surgery, heart attacks, heart failure, hip and knee replacements, and pneumonia.
