Readmission reduction: A losing battle?

Readmissions may be "beyond a hospital's control," according to a new study published in the American Journal of Managed Care.

Researchers, led by Ariel Linden of the University of Michigan School of Public Health, analyzed more than 500 patients in two Oregon community hospitals. They gave half the patients an intervention featuring pre-discharge education and planning, post-discharge follow-up, an available hotline and "bridging" techniques such as daily symptom checks.

Linden and his coauthor, Susan W. Butterworth, Ph.D., found no statistical difference in readmissions between the two groups after both 30-day and 90-day periods, although mortality was lower in the intervention group than the control group.

The community hospitals analyzed in the study could not compel primary care physicians (PCPs) to collaborate with them to prevent acute events post-discharge lack of impact from the interventions. The research found only a single instance where a patient received same-day care from a PCP, and in that case the issue was dealt with without requiring emergency care. Linden and Butterworth cited several cases in which patients sought an appointment with their PCPs for non-emergency conditions but were sent to the emergency room or unable to make an appointment for weeks.

These findings have potential implications for hospital ownership of physician practices, Linden said in a statement. "While hospitals owning physician practices may have negative ramifications for pricing of services in the marketplace, this may be the way to bring more control over the process of reducing readmissions," he said.

This research comes in the wake of readmission penalties reaching a record high earlier this month. The Centers for Medicare & Medicaid Services will levy penalties on more than 2,600 hospitals and half of the hospitals in 29 states and the District of Columbia will be subject to them, FierceHealthcare previously reported.

To learn more:
- here's the study abstract
- read the announcement

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