Hospital Readmissions a Complex Issue

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Karen Utterback By Karen Utterback 
Former Vice President, Product Marketing and Strategy, McKesson (Retired)
An elderly man in a hospital bed

Growing evidence suggests a hospital’s patient population contributes greatly to its 30-day readmission rates and serves as a reminder of the role that home health can play to help patients stay in their homes.

A recent study from Harvard Medical School researchers reveals that nearly one-half of all 30-day readmission rates can be attributed to factors other than those identified by the Centers for Medicare & Medicaid Services (CMS). The socioeconomic and functional status of patients, education level and self-reported health status are among the most important of 29 patient characteristics studied beyond the criteria used by Medicare.

Of the 29 additional characteristics, 22 “significantly predicted” the possibility of readmission, and 17 were differently distributed between hospitals in the highest quintile and the lowest quintile.

“Hospital readmissions are complex and can result from any number of factors, like poor health literacy or lack of access to transportation,” said Michael Barnett, MD, lead author and research fellow at HMS and Brigham and Women’s Hospital. “Therefore, it’s crucial to have a comprehensive picture of patients’ social and clinical context when assessing hospital quality.”

CMS continues to tweak the formula that determines whether a hospital has its Medicare payments reduced, and this new research is not likely to affect the agency’s immediate plans. Despite any changes that might occur, however, the shift from volume to value-based payments and bundled payments for taking care of a population of patients will continue.

So, too, will the important role that home health plays in helping patients recuperate and rehabilitate following hospital stays. In fact, this latest study should serve as a reminder that home care organizations should be looking to partner with local health systems–especially ­ safety net hospitals–to provide critical services in patients’ homes.

It’s not only good business; it’s also in the best interest of patients and providers.

Learn more about how home health can be used to ground ER frequent fliers.

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