In an effort to help patients avoid unnecessary and avoidable hospital readmission after an illness, a program known as the Hospital Readmission Reduction Program, or HRRP for short, was created.
This program, which was established in 2012 as part of the Affordable Care Act, penalizes hospitals financially if readmission rates for certain illnesses are higher than expected. If you want to help your hospital avoid financial penalties for readmission, it’s important that you learn several important hospital readmission statistics.
The statistics provided here can be used to help you anticipate whether or not your hospital is providing quality care and avoiding preventable hospital readmissions or if improvements, using innovative approaches, is needed.
Taking a Closer Look at Hospital Readmission Statistics
Every hospital's statistics and organizational benchmarks will vary depending upon size, type of hospital, patient demographic, services provided, and other characteristics. However, data collected from QualityNet, The New England Journal of Medicine, and the Centers for Medicare & Medicaid Services can help you assess how your hospital is performing when it comes to hospital readmissions.
Some of the important hospital readmission statistics include the following:
- Hospitals should aim for a 100 percent benchmark rate of influenza immunization. Providing this immunization to patients prevents readmission for complications associated with the flu and other illnesses.
- The national rate for influenza immunization in the first quarter of 2017 was 94.5 percent.
- Hospital readmissions that occur within 30 days of a discharge cost Medicare approximately $17 billion.
- Hospitals that underperform could face a financial penalty of up to 3 percent of the hospital's Medicare base diagnosis-related-group payments.
- Hospital readmission rates for targeted conditions, such as pneumonia, heart failure, and acute myocardial infarction, have been decreasing over the years, though at a declining rate recently. In 2015, these targeted conditions only accounted for 17.8 percent of all 30 day readmissions, but are priority conditions for HRRP.
- Patients between the ages of 75 and 84 accounted for the highest number of 30-day hospital readmissions. They accounted for 35.6 percent of hospital readmissions in 2015.
11 percent of hospital readmissions are directly related to non-adherence to medication recommendations.
Avoiding Potential Financial Penalties Through Innovation
Kaiser Health News reported that every year 1,621 hospitals are penalized every year for failure to meet benchmarks set up by the Centers for Medicare and Medicaid Services.
One innovation for potentially avoiding penalties is by automating patient engagement to stay connected with patients once they are discharged from the hospital. For example, the PatientBond cloud-based platform automates digital patient communications (text messages, email, Interactive Voice Response) using a proprietary psychographic segmentation model to personalize all communications according to a patient’s attitudes, values, personality and motivations. This model was developed by healthcare consumer experts from Procter & Gamble and has proven highly effective in changing patient behaviors.
A case study developed by PatientBond shows just how effective this type of digital patient engagement can be. It’s based on a pilot at a renowned New England hospital, in which PatientBond was used to improve patient engagement and follow-up after a hospital discharge from a form of spinal surgery.
Some of the results from the pilot include:
- Only one hospital readmission occurred throughout the course of the eight-month pilot (note, this result has continued beyond the pilot to 20 months)
- Over 85 percent of the patients were actively involved with the communication process.
- Time spent by nurses administering phone follow-up was reduced by 75 percent.
- The hospital was able to save approximately $20 for every $1 it invested into the program.
With these hospital readmission statistics, a hospital administrator can assess hospital operations, improvement opportunities, and consider steps to avoid future penalties that could have a dramatic impact on a hospital's finances.