Hospitals make slow progress on readmissions

Hospitals haven't made much progress on readmissions, according to today's report by the Robert Wood Johnson Foundation. Using data from the Dartmouth Atlas of Health Care, the study found readmission rates of elderly patients in 2010 were similar in 2008, suggesting the needle hasn't moved much on readmissions.

In 2010, 15.9 percent of seniors hospitalized for nonsurgical reasons were readmitted within a month, compared with 16.2 percent in 2008. For surgical readmissions, 12.4 percent of seniors readmitted in 2010, compared with 12.7 percent in 2008.

Hospital administrators are taking note, especially because of regulatory reimbursement changes last year. Starting in October 2012, Medicare began penalizing hospitals that have higher-than-average rates of heart failure, pneumonia or heart attack readmissions.

Twenty-four percent of the 50 LifePoint Hospitals face penalties as a result, Bloomberg reported on data from the Centers for Medicare & Medicaid Services. Meanwhile, only 4 percent of Tenet's 49 hospitals face fines, and only 2 percent of HCA's 162 hospitals do.

Motivated by reimbursements, hospital leaders are certainly paying more attention to their readmission rates, including the effects of regional differences.

The Robert Wood Johnson Foundation noted geographic variations affect readmission rates, presumably because certain hospitals in larger cities care for sicker or poorer patients.

For example, the readmissions rate for medical admissions in the Bronx, N.Y., was 18.1 percent in 2010, compared to 11.4 percent in Ogden, Utah. For surgical admissions, 18.3 percent of patients in the Bronx readmitted, while7.6 percent in Bend, Oregon, returned to the hospital.

Nancy Foster, vice president of quality and patient safety policy at the American Hospital Association, told Bloomberg there are some factors outside of hospitals' abilities.

"You could and should expect hospitals to do more than we have, but we can't fix a broken infrastructure in a community," she said.

Even though progress has been slow, Medicare Deputy Administrator Jonathan Blum told the Associated Press, "We're at a very promising moment."

"Two years ago, the response was, 'This is impossible.' Now it's, 'OK, let's figure out what works," Blum said.

For more information:
- read the Robert Wood report (.pdf) and map
- here's the Bloomberg article
- see the AP article

Related Articles:
Problem of hospital readmissions, benefits of telemedicine hit home
Take community approach to reduce readmissions
Biggest losers of readmission penalty: Big hospitals, safety nets
Post-hospital syndrome fuels readmissions
Readmission penalties may hit safety nets hard