A readmission is a return hospitalization after discharge and most often measured within 30 days of initial hospital stay. Readmissions are common, expensive and frequently preventable. Nearly 20 percent of Medicare patients who are discharged from a hospital are readmitted within 20 days (Jencks, Williams & Coleman, 2009). The conditions with the most Medicare readmissions in 2011 were: congestive heart failure, non-hypertensive; septicemia; pneumonia; chronic obstructive pulmonary disease and bronchiectasis; and cardiac dysrhythmias (Hines et al., 2014). A growing body of evidence suggests that unplanned readmissions are associated with lower quality of care (Benbassat & Taragin, 2008).
Unplanned readmissions are frequently the result of ineffective discharge processes including discharge planning, medication reconciliation, failed hand-offs and insufficient patient education (Kripalani et al., 2007; Forster et al., 2005; Forster et al., 2003).
In addition to concerns regarding quality, readmissions are also very costly to the health care system and to patients. In 2011, 3.3 million adult readmissions occurred in the United States with an associated hospital cost of $41.3 billion (Hines et al., 2014). In 2012, CMS implemented the Medicare Hospital Readmissions Reduction Program which penalizes hospitals for readmissions. Under the Medicare Hospital Readmissions Reduction Program, 2,610 hospitals were fined in 2014 (Rau, 2014). In 2015, the maximum penalty for inpatient hospital payments is 3 percent, a significant incentive for hospitals to reduce unplanned readmissions.
From 2011 to 2014, the AHA/HRET HEN prevented an estimated 65,022 readmissions with an estimated cost savings of over $572 million. From September 2015 to September 2016, the AHA/HRET HEN 2.0 prevented an estimated 8,040 readmissions with an estimated cost savings of over $124 million.
12 percent reduction in 30-day readmissions as a population-based measure (readmissions per 1,000 people) by September 27, 2018.Partnership for Patients (PfP) Goal
To achieve the readmissions reduction goal of 12 percent, we encourage you to utilize the resources available through this website. Strategies to reduce readmissions include a change package, top ten checklist, past virtual events and other resources, which are available for download below.
Outcome measures provide a common language helping to assess the quality of care in hospitals. Below are the HRET HIIN readmissions outcome measures.
More information about these measures can be found in the HIIN Encyclopedia of Measures.