Readmissions data now reported by CMS
CMS released a statement on Thursday, July 9, saying that its Hospital Compare Web site will now contain data reporting how frequently patients return to a hospital after being discharged, “a possible indicator of how well the facility did the first time around,” says the statement.
The statement goes on to say that, on average, one in five Medicare beneficiaries discharged from a hospital is readmitted within a month. President Obama and Congress are focusing on reducing readmissions as a way to improve quality and achieve cost savings, according to the statement.
Hospital Compare data show that 19.9% of patients admitted to a hospital for heart attack treatment 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.
“Research has shown that hospital readmissions are reducing the quality of healthcare while increasing hospital costs,” the statement reports.
“Providing readmission rates by hospital will give consumers even better information with which to compare local providers,” said Charlene Frizzera, CMS Acting Administrator. “Readmission rates will help consumers identify those providers in the community who are furnishing high-value healthcare with the best results.”
CMS has also changed the way it calculates mortality rates. In past years, it used only one year of claims data to compute mortality, while now it will use three years of claims data.
CMS says that reporting three-year mortality data will also help inform the public about hospital quality. Using the three-year data method, CMS estimates that the national 30-day mortality rate for patients originally admitted for heart attack care is 16.6%. For heart failure patients, the national 30-day mortality rate is 11.1%, and for pneumonia patients, the national rate is 11.5%.
The Hospital Compare Web site will show whether a hospital’s mortality or readmissions rate is “better than,” “no different from,” or “worse than” the U.S. national rate.
Hospital Compare also includes 10 measures that capture patient satisfaction with hospital care, 25 process of care measures, and two children’s asthma care measures. The site also features information about the number of selected elective hospital procedures provided to patients and what Medicare pays for those services.
The Hospital Compare Web site can be found at www.hospitalcompare.hhs.gov.
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I’m curious how you, as case managers, feel about readmissions data being added to Hospital Compare. Is readmissions data an accurate assessment of hospital quality? What are other factors that should be considered when assessing readmission rates?
About the Author: Julie works in the case management market at HCPro, Inc. She works on all of HCPro’s product lines for case managers including books, audio conferences, journals, videos and an eNewsletter. To contact her with questions, comments, or to be a blog writer, email jmcginley@hcpro.com.
Jenny Stelzner | Jul 15, 2009 | Reply
I don’t totally agree that the readmission rate is a good predictor for hospital quality. While some readmissions can be prevented, there are some that can not. Many of us have encountered patients who are noncompliant with post-hospital care. In addition, there are patients that are offered post-hospital services, such as home care, but refuse these services, or perhaps “fall through the cracks” because the patient did not meet criteria for using these services.
Tonya Speights | Jul 15, 2009 | Reply
I do not agree that they are a good quality indicator. The patient is sick, not all patients are going to get better. We know as a matter of fact that they are gauranteed to get worse. We have increased the severity of illness a patient has to meet just to get in the hospital, said the length of stay has to be shortened, limited funds for post hospital care, and then cant figure out why the patient isn’t better and cant be managed at home. Hospitals are being put in a vice grip from all sides. A constant no win situation.
Wendy Dwyer | Jul 17, 2009 | Reply
The hospital’s cuklture and demographics should be taken into consideration when reporting readmission data. We serve a large population of frail elders compared to some other local hospitals which has to affect readmissions, they are weak, likely have more comorbidities and cannot bounce back as well as a younger population in my opinion.
Jerry Christy, RN | Jul 20, 2009 | Reply
We have started a readmission process to screen possible failed OP discharge plans. Patients readmitted within 30 days are earmarked,case managed throught the hospital stay, and a more intense DC plan is developed, ie. home health for SNV for medication management, medication compliance, weight/fluid management, Pt, etc. The goal is to reduce readmissions through improved DC planning are all patients.