Editorial

Curbing Readmission Rates: An Uphill Task

Authors: Vineet Gupta, MD, Anthony J. Pinevich, MD, MBA

Abstract

In this issue of the Southern Medical Journal, Cakir and Gammon1 assess patient readmission rates for the same diagnosis within one month of initial discharge at a community hospital. Escalating health care costs and financial deficits have compelled policy makers and hospital administrators to identify measures for expense reduction. A focus on reduction of hospital readmissions has been touted as a potential opportunity for improving health care quality and reducing related expenditures. The Medicare Payment Advisory Commission (MedPAC) and the Centers for Medicare and Medicaid Services (CMS) currently do not reimburse for same-diagnosis hospital readmissions occurring within 30 days of hospital discharge.2 Even so, MedPAC has estimated that readmissions result in an additional $15 billion in annual Medicare expenditures.3 Further, Medicare reimbursement reductions proposed for implementation in fiscal year 2013 will specifically target hospitals with high readmission rates.

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References

1. Cakir B, Gammon G. Evaluating Readmission Rates: How Can We Improve? South Med J 2010;103:1079–1083.
 
2. Wilensky GR. Reforming Medicare's physician payment system. N Engl J Med 2009;360:653–655.
 
3. Averill RF, McCullough EC, Hughes JS, et al. Redesigning the Medicare inpatient PPS to reduce payments to hospitals with high readmission rates. Health Care Financ Rev 2009;30:1–15.
 
4. Available at: http://www.hospitalcompare.hhs.gov. Accessed on June 12, 2010.
 
 
5. Goldfield NI, McCullough EC, Hughes JS, et al. Identifying potentially preventable readmissions. Health Care Financ Rev 2008;30: 75–91.
 
6. Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med 2009;360:1418–1428.
 
7. Jack BW, Chetty VK, Anthony D, et al. A reengineered hospital discharge program to decrease rehospitalization: a randomized trial. Ann Intern Med 2009;150:178–187.
 
8. Maguire P. Have a problem with readmissions? Why bouncebacks might be next big thing for hospitalists. Today's Hospitalist, June 2009. Available at: http://www.todayshospitalist.com/index.php?b=articles_read&cnt=810. Accessed June 12, 2010.