Readmissions lead to $41.3B in additional hospital costs

Hospitals spent $41.3 billion between January and November 2011 to treat patients readmitted within 30 days of discharge, according to the Agency for Healthcare Research and Quality (AHRQ).

Some 1.8 million readmissions cost the Medicare program $24 billion; 600,000 privately insured patient readmissions totaled $8.1 billion; and 700,000 Medicaid patient readmissions cost hospitals $7.6 billion, according to the AHRQ.

The 200,000 uninsured patients who were readmitted cost hospitals a relatively paltry $1.5 billion.

The top medical conditions among Medicare patients are fairly commonplace: Congestive heart failure led the pack, with 1.35 million readmissions at a cost of $1.7 billion. Septicemia was second, with 92,000 readmissions, which amounted to $1.4 billion, followed by pneumonia, with 88,000 readmissions and $1.1 billion in additional costs, according to the study.

Hospitals spend far less money to treat readmitted Medicaid patients, but the conditions are much different. Mood disorders and serious mental illnesses, such as schizophrenia, led to 77,400 readmissions and $588 million in additional costs. Unchecked diabetes led to 23,700 readmissions and cost $251 million.

In the private sector, complications related to chemotherapy caused 25,500 readmissions and $400 million in additional costs. Cancer treatments are among the costliest forms of healthcare delivery in the hospital setting. Complications from surgical procedures caused 18,000 readmissions and $250 million in additional costs. Some hospitals now use quality improvement tools to reduce such readmissions.

Most payers also suggest that better coordination of post-discharge care would likely reduce the number of readmissions.

"[I]dentifying conditions that contribute the most to the total number of readmissions and related costs for all payers may aid healthcare stakeholders in deciding which conditions to target to maximize quality improvement and cost-reduction efforts," the AHRQ said in the study. The Centers for Medicare & Medicaid Services--which financially penalized two-thirds of hospitals last year for their readmission rates--will expand its efforts to cut costs associated with readmissions next year beyond acute myocardial infarction, pneumonia and heart failure starting next year, the agency noted.

To learn more:
- here's the AHRQ study (.pdf)

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