High-Risk Readmissions: Strategies for Management and Prevention
In its 10th annual round of penalties, Medicare is reducing its payments to 2,499 hospitals, or 47% of all facilities for readmissions. The average penalty is a 0.64% reduction in payment for each Medicare patient stay from October 2021 through September 2022.
What are We Learning About Readmissions?
The common thought that socioeconomics is a main influencer of readmissions is not the key. It’s about the quality-of-care transitions at discharge. See article: Is Socioeconomics a Main Influencer of Readmissions?
- 20% of adult hospital readmissions are associated with four conditions. See article: 30-Day Readmissions: Managing Clinical Conditions to Prevent Readmits.
- In 2018, there were 3.8 million 30-day all-cause hospital readmissions, with a 14% readmission rate and an average readmission cost of $15,200.00. See details: DataPoint: Readmissions by Payer.
- Readmissions after a SNF discharge following heart failure hospitalizations is highest during the first two days home. See article: High Risk of Readmissions: Skilled Nursing Facility to Home.
- 20 states have readmissions over 15%. Learn more: Hospital Readmissions, Ages 65-74, by State.
- 30 chronic conditions managed in the home decreased Medicare expenditures. See article: Which Chronic Conditions Managed by Home Care Services Reduce Medicare Spending?
Readmissions are complex because the root causes can be traced back to appropriate care sites, discharge planning, and timely care transitions.
Two studies verify these findings. See article: Discharge Planning Patterns: Care Transitions and Readmissions, and Timely Care Transitions: Planning the Next Site of Care as The Priority.
Nearly half of the nation’s hospitals are penalized for readmissions in the first decade the program began. We can do better! Look at our recommendations and strategies to help move the needle.
Lisa is a turnaround expert who excels in navigating unsteady, complex, and ambiguous environments. She has provided C-suite education to over 10,000 organizations in the home care sector for decades. Lisa’s trusted voice in the industry has been recognized for her ability to manage disruption, identify new growth and revenue opportunities, and develop high-level engagement strategies between home care and referral partnerships. Her contributions are instrumental in advancing the future of home care.
