AHA report: Not all readmissions avoidable, 'ill-suited' quality indicator

Even with national attention on reducing readmissions, a new report from the American Hospital Association indicates that not all readmissions can or should be avoided.

In 2009, hospitals began to voluntarily report their readmission rates to the Centers for Medicare & Medicaid Services (CMS), available data open to the public on Hospital Compare. Congress took it a step further by issuing under health reform the Hospital Readmissions Reduction Program, in which Medicare will penalize hospitals for high readmissions rates, starting in 2013.

Nearly one-fifth of Medicare beneficiaries (2 million people) that are discharged from the hospital return to the hospital within 30 days, according to the Medicare Payment Advisory Commission, reports AHA News Now.

Although most agree that preventable readmissions should be avoided for the patients' sake, many disagree on what constitutes "preventable," saying readmissions may not reflect quality and arguing reduced reimbursement actually might be unfair. In addition, there are other correlating factors, including socioeconomic class, support, and comorbidity that might influence readmission rates, according to the report.

The report separates readmissions into different classes (planned, unplanned, related, or unrelated to initial admission). It notes that public policy should focus on unplanned readmissions related to the reason for initial admission for savings and care improvements.

"Payment penalties intended to shrink readmission rates could exacerbate inequities and leave hospitals with fewer resources to make needed investments in improving patient care," states the report. "Further, misaligned policies could direct hospitals to reduce readmissions that are appropriate for safe patient care and may actually save lives."

For more information:
- read the report (.pdf)
- read the news brief

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