A Hidden Cause of Readmissions Comes to Light
All-Cause Readmission Rates
The Centers for Medicare & Medicaid Services tracks readmissions of patients with heart failure, pneumonia, and heart attack, and punishes hospitals with higher rates by reducing reimbursement by up to 3% of their total base Medicare payment. Starting this October, CMS says, excess readmissions for patients with chronic obstructive pulmonary disease, another medical condition, will be added, as well as total hip and knee procedures, the first surgeries in the algorithm.
Hospitals will soon begin reporting to Medicare their all-cause readmission rates. And officials at CMS have proposed including in the penalty those patients readmitted after coronary artery bypass surgery, bariatric surgery, and vascular surgery, although those procedures are not yet in the readmissions reduction program.
I asked Hawn if quality improvement organizations would push back on her claim that hospitals aren't working hard enough to reduce readmissions among their surgical patients.
Hawn stuck to her guns. "There are probably some out there that are [working hard enough] but I don't think every organization is doing it. It's very resource-intensive. And I don't think they're doing much work around surgery because it's such a diverse group of patients and conditions, with very different complications and reasons for readmissions."
Besides, Hawn says, "they're all mainly focused on the medical conditions now, because that's where the money is at risk now."
That is soon going to change.
Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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