Medicare hospital readmissions reduction program

Readmissions Program Failing Some Heart Patients?

The 30-day mortality rate has risen for heart failure patients since Medicare’s hospital readmission reduction program was implemented. According to a new study published in JAMA, the 30-day mortality rate for heart failure patients rose 0.49 percent between 2007-2010 and 2010-2012 and another 0.52 percent between 2010-2012 and 2012-2015. Similar results were not found for the other types of patients whose readmission rates are measured under the program: patients who were hospitalized for heart attacks, heart bypass surgery, pneumonia, chronic obstructive pulmonary disease, and hip or knee replacement. The heart failure findings, though, raise the question of whether performance under [...]

iqtsupport2018-12-28T06:00:49-05:00December 28, 2018|Medicare regulations, Medicare reimbursement policy|

MedPAC Issues 2018 Report to Congress

The non-partisan legislative branch agency that advises Congress and the administration on Medicare payment policies has submitted its mandatory annual report to Congress. Among the findings included in the report by the Medicare Payment Advisory Commission are: Medicare’s hospital readmissions reduction program has not resulted in increases in emergency room visits or hospital observation stays. Many Medicare accountable care organizations, while maintaining or improving quality, are producing more modest savings than predicted. MedPAC approves of Medicare’s proposals to redesign the case-mix classification system for skilled nursing facilities. MedPAC supports changes Medicare has proposed for patient assessment and therapy requirements for [...]

iqtsupport2018-06-21T10:33:14-04:00June 21, 2018|Accountable Care Organization, ACO, hospitals, Medicaid, Medicare, Medicare post-acute care, Medicare regulations, MedPAC, post-acute care|

Study Raises Questions About Progress Toward Reducing Readmissions

A new study suggests that the reduction in hospital readmissions of recent years may not be as meaningful a reflection of improved quality of care as some observers believe. According to a new study published in the New England Journal of Medicine, at the same time that hospitals have reduced their readmissions of Medicare patients in response to penalties imposed through Medicare’s hospital readmissions reduction program, the rate of readmission of patients who are hospitalized for observation stays after visiting the emergency room has increased 35 percent. This increase in readmissions for observation stay patients comes at a time, moreover, [...]

iqtsupport2018-06-05T10:03:22-04:00June 5, 2018|Medicare|

Time to Raise the Bar on Preventable Hospital Readmissions?

A new report suggests that hospitals can have the greatest impact on reducing preventable readmissions within seven days of discharge and not through the 30-day mark at which they are currently judged by Medicare. According to a study published in the Annals of Internal Medicine, Early readmissions were more likely to be preventable and amenable to hospital-based interventions. Late readmissions were less likely to be preventable and were more amenable to ambulatory and home-based interventions. The study, conducted at 10 academic medical centers and involving more than 800 of their patients who had been readmitted to the hospital, concludes that [...]

iqtsupport2018-05-03T06:00:37-04:00May 3, 2018|Medicare, Medicare regulations|

Readmissions Program Working; Expansion in Order?

The Medicare hospital readmissions reduction program is working, according to the Medicare Payment Advisory Commission. And it may even be worth expanding to additional medical conditions, MedPAC members believe. According to MedPAC, hospital readmissions among patients with medical conditions covered by the readmissions reduction program have declined faster than readmissions among patients with medical conditions not covered by the program, suggesting that expanding the program to additional medical conditions could lead to an even greater reduction in the number of avoidable Medicare-covered readmissions. Learn more about changes in the readmission rate since the readmissions reduction program was introduced and whether [...]

iqtsupport2018-03-07T06:00:23-05:00March 7, 2018|Medicare, Medicare regulations, MedPAC|

MedPAC Meets

The Medicare Payment Advisory Commission, which advises Congress on Medicare payment issues, met last week in Washington, D.C. Among the issues on MedPAC’s agenda were: paying for sequential stays in a unified Medicare payment system for post-acute care encouraging Medicare beneficiaries to use higher-quality post-acute care providers using payment policy to ensure appropriate access to and use of hospital emergency department services the Centers for Medicare & Medicaid Services’ financial alignment demonstration for dual-eligible beneficiaries the effectiveness of the Medicare hospital readmissions reduction program population-based quality measures such as preventable admissions and home and community days Go here, to MedPAC’s [...]

iqtsupport2018-03-05T06:00:23-05:00March 5, 2018|Medicare, Medicare post-acute care, Medicare regulations, MedPAC|

Lay Outreach Workers Reduce Readmissions

A community hospital in Kentucky has found that employing lay outreach workers to assist patients recently discharged from the hospital can significantly reduce hospital readmissions. In a research project, the hospital identified high-risk patients and, upon their discharge from the hospital, assigned lay outreach workers to help those patients with matters such as providing transportation, assisting during follow-up medical appointments, and navigating the health care system. With this help, the hospital experienced a 48 percent reduction in 30-day readmissions. While the hospital needed to spend money to employ the outreach workers, the effort reduced its likelihood of being assessed penalties [...]

iqtsupport2018-02-28T06:00:39-05:00February 28, 2018|Medicare, Medicare regulations|

Is Readmissions Reduction Program Hurting Some Patients?

A new study suggests that the decline in avoidable hospital readmissions of Medicare patients driven by the federal program’s hospital readmissions reduction program may be harming cardiac patients. According to a new study published in the journal JAMA Cardiology, while the readmissions reduction program has reduced readmissions among heart failure patients from 20 percent before the program was launched to 18.4 percent, the mortality rate among the same patients rose from 7.2 percent to 8.6 percent – 5400 more deaths a year. To learn more about the study, its results, why experts believe this may be happening, and information about [...]

iqtsupport2017-11-29T06:00:23-05:00November 29, 2017|Medicare|

Improvements Inspired by Readmissions Reduction Program Level Off

After major improvements during the early years of Medicare’s hospital readmissions reduction program, the program is no longer showing significant new gains. While Medicare readmissions have fallen from 21.5 percent to 17.8 percent since 2007, there has been very little improvement since 2012, suggesting that most of the benefits from the program have already been achieved. And in FY 2018, Medicare will penalize almost the same number of hospitals it penalized in FY 2017: approximately 80 percent of the hospitals subject to the program. In FY 2018, the average penalty will be 0.73 percent of affected hospitals’ Medicare payments. Forty-eight [...]

iqtsupport2017-08-08T06:00:18-04:00August 8, 2017|Medicare regulations|

Mortality Doesn’t Go Up When Readmissions Come Down

The emphasis in recent years on reducing hospital readmissions has not resulted in an increase in post-discharge deaths among Medicare patients. Or so concludes a new study published in JAMA. Looking at outcomes associated with Medicare’s hospital readmissions reduction program, the study “Association of Changing Hospital Readmission Rates With Mortality Rates After Hospital Discharge” found that … of more than 5 million Medicare fee-for-service hospitalizations for heart failure, acute myocardial infarction, and pneumonia from 2008 to 2014, reductions in hospital 30-day readmission rates were weakly but significantly correlated with reductions in 30-day mortality rates after hospital discharge. Learn more about [...]

iqtsupport2017-07-19T15:21:29-04:00July 19, 2017|Medicare|