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Patient Readmission

Readmissions
Reducing readmissions is a priority for Hospitals across the nations seeking to accomplish the Institute for Healthcare Improvement Triple Aim, improved health, better care, at lower cost. This priority can be achieved through an improved delivery system that manages care across settings and over time to avoid unnecessary acute-care utilization, including readmissions.
Subject matter experts estimate the average cost is $15,477 per readmission. Preventable readmissions can lead to:

  • Wasteful resource utilization
  • Unnecessary tests and procedures
  • Potentially harmful treatments
  • Delays in patient care
  • Decrease adequate patient access to care, and a hospitals capacity to provide care
Work to reduce readmissions requires hospitals and delivery systems to develop the infrastructure, care teams, processes, and partnerships needed to succeed in the value-based payment environment of the future.
WHA regularly displays readmission rates on its CheckPoint website so hospitals can compare their performance and see how Wisconsin compares to the rest of the nation.  Checkpoint shows data for All Cause Readmissions as well as the 6 Centers for Medicare & Medicaid Services subject to reduced Medicare payments for excess 30-day readmissions rates for patients with:
  • Heart attack
  • Heart failure
  • Pneumonia
  • Chronic obstructive pulmonary disease
  • Hip/knee replacement
  • Coronary artery bypass graft surgery
Initiatives
Over 80 Wisconsin hospitals participate in the Great Lakes Partners for Patients Hospital Improvement Innovation Network (www.greatlakespfp.org) to work on achieving a 12% reduction in 30-day readmissions by March 2020.
Over the past several years, WHA has offered large-scale improvement efforts through the GLPP HIIN to help Wisconsin Hospitals address social and behavioral needs in efforts to reduce admissions and readmissions.
WHA is supporting hospitals address readmission through:
  • Readmissions Tracking: the rate
  • Interactive events such as training workshops, hospital mentoring, webinars, coaching calls, and networking opportunities focused on evidence based, innovative strategies that increase patients’ satisfaction, reduced harms, and decreased costs related to ED recidivism, avoidable readmissions, and preventable readmissions.
Resources:
Centers for Medicare and Medicaid (CMS) Learn more about the Medicare value-based purchasing program developed to support the national goal of improving healthcare for Americans by linking payment to the quality of hospital care. Learn more about model established to support better and more efficient care for Medicare beneficiaries undergoing the 2 most common inpatient surgeries, hip and knee replacements. Both procedures are included in the Hospital Readmissions Reduction Program (HRRP).
Centers for Disease Control and Prevention (CDC) Learn more about the Hospital Improvement Innovation Networks (HIINs) initiative to sustain and accelerate quality improvement progress and momentum towards continued harm reduction in hospitals.
Learn more about the conditions included in the CMS Hospital Readmissions Reduction Program (HRRP). Great Lakes Partners for Patients Hospital Improvement Innovation Network Wisconsin Hospital Association