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Preventing Hospital Readmissions Presents Financial Paradox

Rene Letourneau, for HealthLeaders Media, June 10, 2013

Mark Sonneborn, vice president of information services at the Minnesota Hospital Association, says these hospitals are well aware of the financial dilemma, but are nonetheless committed to preventing readmissions.

"First and foremost we consider readmissions to be [an indication of] suboptimal care, even though in a fee-for-service way of doing things, a hospital is paid for doing both the admission and readmission," he says.  

"Even with Medicare penalties, a CFO could do the calculations and find it is still worth it to have the readmission despite the penalty… There is still some wariness that we are not there yet, and haven't really shifted from a fee-for-service to a value-based payment structure. There is a worry about shifting too soon in terms of the bottom line, but everyone agrees this is the right thing to do."

Sonneborn's take on the readmissions conundrum rang true to me. At a recent meeting with three health system CEOs, I heard lots of conversation about the financial challenge created by preventing readmissions while still operating in a predominately fee-for-service world. Although all three were clearly concerned about the money, they kept coming back to one point: It's about doing what is best for the patient.

This is also the theme I heard when I spoke to a few of the hospitals that are taking part in the RARE Campaign.

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