After a hospital and CMS are on the same page regarding readmission rate measures, the next step is for the facility to monitor performance and identify areas for improvement. "Once they understand how the measures are calculated and how their rates compare to the national rates and state average, some hospitals choose to calculate their raw (unadjusted) readmission rates to more closely monitor their performance on these measures as they work on improving their systems for transitioning patients to the outpatient setting, collaborating with communities and providers, and communicating with patients and caregivers," he said.
CMS is also providing resources to help hospitals build readmission intervention programs. "CMS [has] designated Quality Improvement Organizations to reduce unnecessary readmissions to hospitals and promote seamless transitions between healthcare settings. Hospitals may reach out to their QIOs for assistance in identifying ways to reduce their readmission rates," he added.
The federal agency has also identified several "initiatives and peer-reviewed studies" that have demonstrated success in reducing readmissions. Those readmission intervention models include Partnership for Patients, a CMS initiative that is pushing participating hospitals to achieve a 40% reduction in hospital-acquired conditions and a 20% reduction in hospital readmissions compared to 2010 levels.
Christopher Cheney is the senior clinical care editor at HealthLeaders.