Massachusetts Efforts To Reduce Readmission Rates Produce Mixed Results
By Christine Kern, contributing writer
A Center for Health Information and Analysis report finds that while unplanned readmissions fell, wide variations also existed.
Massachusetts has achieved mixed results in its efforts to cut unplanned hospital readmissions from 2011 to 2013 according to the state’s Center for Health Information and Analysis (CHIA). The report found that while unplanned readmissions fell each year, a small portion of the patient population continued to account for most readmissions.
This study is significant because hospital readmissions are a central issue in improving the quality of healthcare and reducing costs. The study’s authors write, “Readmission within 30 days of a prior hospitalization has been identified as a costly and potentially preventable problem, both nationally and in Massachusetts. In Massachusetts, the Centers for Medicare and Medicaid Services (CMS) penalized 80 percent of acute hospitals for higher-than-expected Medicare readmission rates in federal fiscal year 2015, and the Commonwealth’s Health Policy Commission estimates readmission costs at $700 million annually.”
The CHIA data for this study was collected from acute hospitals statewide, and the study is one of the first examinations of readmissions across payer types and not just the Medicare fee-for-service population, according to FierceHealthcare. The assessments by the Center for Medicare & Medicaid Services have focused on that particular population to date.
The report found unplanned readmission throughout the state did fall each year between 2011 and 2013, but it also revealed a wide variation across categories, including payer type, discharge setting, and patient age. According to the CHIA report, 7 percent of patients accounted for 25 percent of all hospitalizations and 59 percent of all readmissions, and most of these patients (68.8 percent) were Medicare patients. The report highlights the opportunities these findings provide to focus on patients who are frequent users, in order to better understand and address their post-acute care requirements.
Among other key findings was readmission rates for those with Medicare and Medicaid were higher (17.3 percent and 17.0 percent) than those with commercial coverage (9.8 percent). “Readmissions among individuals covered by public payers comprise 81 percent of all readmissions in the state,” the report notes.
Perhaps most significantly, after accounting for differences in patient cases and hospital services, the report finds few hospitals achieved readmission rates statistically different from the statewide rate, suggesting that the issue of reduced readmissions is still not satisfactorily resolved. “Of the 62 acute care hospitals included in this analysis, four had adjusted readmission rates above the state average and two had adjusted readmission rates below the state average,” it says.