Hospital Readmission

Hospital readmission is a serious problem in the United States, and it is by no means a new problem. There are many facts and theories about why hospital readmission has become such a major issue such as, lack of HealthCare plan literacy, faulty medication adherence and uninformed mixtures of medications. As well as, deficiency of access to a Primary Care Physician within two weeks of discharge and absence of family and caregiver support at home. 75% of hospitals in the US will receive fines this year for readmissions, the DC area has one of the highest readmission rates in the country.

Some facts on Hospital Readmissions within 30 days

  • 1 in 5 Medicare patients are readmitted within 30 days of discharge, 2 million patients/ year.
  • 34% are readmitted within 90 days
  • Cost of Medicare is $29B/year
  • Avoidable cost to Medicare $17B/year
  • Cost/patient/readmission: $7,200

In October 2012, the Center for Medicaid and Medicare Services (CMS) started the Hospital Readmission Reduction Program. THe program provides a financial incentive to hospitals to reduce their readmission rates below the national average. In 2013 the penalty will be 1%, in 2014 2% and in 2015 3%. CMS began penalizing for three diseases first, AMI – Heart Attack, CHF – Congestive Heart Failure and PN – Pneumonia. Following that, COPD and Hip and Knee replacement were added to the list. In October 2015 the penalty will apply to all readmissions regardless of the disease or condition.  For this reason, the idea of switching to a fee for outcome rather than a fee for service model is extremely attractive. The goal is to create a financial incentive to hospitals to decrease their rates of readmission to below the national average.

As a leader in hospital readmission mitigation we, at Georgetown Home Care, have created a program to help the hospitals in our area achieve their goals of reducing unnecessary readmission, but more importantly helping people stay in the comforts of their one home. This program is called Welcome Home. Please visit the Welcome Home page here to learn more.