All in the Numbers: Making Sense of Hospital Compare Readmission Data
The Centers for Medicare and Medicaid Services (CMS) released this month first-time data in its Hospital Compare Web site that reports if patients returned to an individual hospital within 30 days after being discharged for three conditions: heart attacks, heart failure, or pneumonia.
Hospital Compare data show that on average for patients admitted to a hospital for heart attack treatment, 19.9% of them will return to the hospital within 30 days, 24.5% of patients admitted for heart failure will return to the hospital within 30 days, and 18.2% of patients admitted for pneumonia will return to the hospital within 30 days.
More than 4,000 hospitals—including almost all acute care hospitals—have voluntarily submitted quality information to share with the public through the Web site. Hospitals were placed in one of three categories based on their readmission rate—compared with the national readmission rate: "no different than the U.S. national rate," "better than the U.S. national rate," or "worse than the U.S. national rate."
So what does this data mean? Is a hospital in trouble if it is ranked "worse" than the national rate? Well, not quite. Even in its own explanation, CMS urges consumers not to view any one process or outcome measure on Hospital Compare as a tool to "shop" for a hospital.
But it's important for hospitals to understand how this current year's data is obtained. First, the data used in the Web site looks at data averaged over a three-year period of time.
"So where improvements have been made in the last year—that's not necessarily going to show up in data right now," said Jayne Hart Chambers, Senior Vice President for Strategic Policy and Corporate Secretary with the Federation of American Hospitals (FAH). FAH is a member of the Hospital Quality Alliance, which has collaborated with CMS on the development of its public quality reporting efforts.
"The other thing to understand about this particular measure is that readmission to a hospital within 30 days . . . is not necessarily related to the underlying condition that [the patient was] originally discharged," Chambers said.
- Healthcare Leaders Seek Strategic Sweet Spot
- 3 Reasons Wellness Programs Fail
- CMS Issues Health Insurance Exchange Proposed Rules
- Patients Shoulder Nearly 25% of Medical Bills
- ACOs Widespread, Yet Challenged
- MGMA: Physician Compensation Increasingly Based on Quality Measures
- HFMA: Patient Financial Interaction Guidelines Sharpened
- 6 CNO-to-CEO Strategies
- HFMA: Revenue Cycle, Reimbursements Share the Spotlight
- PwC: Pace of Rising Medical Costs Slowing