​​​​​​​Quality improvements reduce readmissions but may not save hospitals money

Researchers at Cedars-Sinai Medical Center took a look at the potential for cost savings with quality improvements aimed at reducing readmissions.

Quality improvement programs aimed at reducing readmissions are often effective, but cutting down readmission rates may not actually offer any cost savings, according to a new study.

In 2016, more than half of U.S. hospitals were penalized by the Centers for Medicare & Medicaid Services for their readmission rates. Research suggests financial penalties do push hospitals to reduce readmissions, but other studies have called into question the effectiveness of such punishments on patient outcomes.

Researchers at Cedars-Sinai Medical Center conducted a systematic review of data from 50 quality improvement studies, which included more than 16,700 patients, according to the study published in JAMA Internal Medicine. The quality improvement interventions included in the prior research proved effective; on average, readmissions dropped by about 12% for heart failure patients and about 6% for older adults with multiple health concerns.

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But the financial benefits varied widely, according to the study. Hospitals saved an average of $972 per person for heart failure patients, but posted an average loss of $169 per person for other patients. However, the cost variations were so huge across the studies in the review that the Cedars-Sinai team couldn’t definitively conclude if reducing readmission rates saves hospitals money.

"Hospitalization is very expensive, so avoiding even a few readmissions should have saved a lot of money," the study’s lead author, Teryl Nuckols, M.D., director of the department of general medicine, said in announcement of the findings. "Our findings suggest that there is no guarantee of net cost savings once the implementation costs associated with efforts to prevent readmissions are considered."

RELATED: Study: CMS penalties unfair, lower readmission rates don't correlate with improved outcomes

he most effective interventions, the researchers found, were those that engaged patients and caregivers; for instance, having clinicians or pharmacists offer clear directives on medication adherence and how to spot symptoms that require a return trip to the doctor.

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