What are avoidable readmissions?

An avoidable hospital readmission occurs when a patient has been discharged from hospital (index admission) and has a subsequent unplanned admission that is related to the index admission and was potentially preventable.

What is the Medicare 30 day readmission rule?

Medicare counts as a readmission any of those patients who ended up back in any hospital within 30 days of discharge, except for planned returns like a second phase of surgery. A hospital will be penalized if its readmission rate is higher than expected given the national trends in any one of those categories.

How can hospital readmissions be avoided?

Let’s examine 7 strategies to reduce hospital readmissions:

1. 1) Understand Current Policy.
2. 2) Identify Patients at High Risk for Readmission.
3. 3) Utilize Medication Reconciliation.
4. 4) Prevent Healthcare-Acquired Infections.
5. 5) Optimize Utilization of Technology.
6. 6) Improve Handoff Communication.

What are the 7 conditions that are addressed in the re admission reduction program?

The HRRP tracks readmissions for Medicare patients admitted initially for six targeted conditions: heart attack, heart failure, pneumonia, chronic obstructive pulmonary disease (COPD), elective hip and knee replacement, and coronary artery bypass graft (CABG).

What are the 6 unplanned readmission measures in CMS?

CMS includes the following six condition or procedure-specific 30-day risk-standardized unplanned readmission measures in the program: Acute myocardial infarction (AMI) Chronic obstructive pulmonary disease (COPD) Heart failure (HF) Pneumonia Coronary artery bypass graft (CABG) surgery Elective

What is AHRQ doing to reduce preventable readmissions?

AHRQ’s tools, data, and research to help hospitals reduce preventable readmissions. AHRQ contracted with Boston University Medical Center to develop this toolkit to assist hospitals, particularly those that serve diverse populations, to re-engineer their discharge process.

Why is it important to reduce hospital readmissions?

Reducing preventable hospital readmissions is a national priority for payers, providers, and policymakers seeking to improve health care and lower costs. In 2012, the Centers for Medicare & Medicaid Services began reducing Medicare payments for certain hospitals with excess 30-day readmissions for patients with several conditions.

What is the 3 percent payment reduction for Medicare?

Payment reductions are applied to all Medicare fee-for-service base operating diagnosis-related group payments during the FY (October 1 to September 30). The payment reduction is capped at 3 percent (that is, a payment adjustment factor of 0.97).