Reducing Post-Hospital Deaths, Not Just Readmission Rates

Medicare has recently been penalizing hospitals with high readmission rates for patients with conditions like heart attack, heart failure and pneumonia. The policy change was based on data showing that readmission for patients with these types of conditions was costing the country billions of dollars.Reducing Post-Hospital Deaths, Not Just Readmission Rates

Learn more about this new approach to reduce readmission rates in addition to post-hospital deaths across the U.S.

Post-Hospital Deaths and Readmission Rates Across the U.S.

Researchers from the University of Michigan Medical School and VA Ann Arbor Healthcare System recently published a study in JAMA Cardiology which shows that the Medicare system is focusing too much on readmission rates and overlooking the importance of low mortality rates.

“If hospitals got paid less when their patients died soon after a hospitalization, just like they get paid less when those patients end up back in the hospital, it would be a game-changer for one-third of hospitals,” the authors of the study concluded.

The study, which is based on 2014 data, found that “about 17% of hospitals are getting punished for excess readmissions, but are keeping patients alive more often than would be expected… and another 16% of hospitals essentially get rewarded for low readmission rates, but their patients are more likely to die in the first month after leaving their hospital beds,” Medical Xpress reports.

“In other words, some of the hospitals that get penalized for high readmissions are those that may actually do the best job at keeping patients alive — and vice versa.”

Rewarding the Wrong Hospitals

Johns Hopkins University School of Medicine published a report in 2015 in the Journal of Hospital Medicine that found a link between hospital readmission rates and low mortality rates. Researchers “found that hospitals with the highest rates of readmission were actually more likely to show better mortality scores in patients treated for heart failure, COPD [chronic obstructive pulmonary disease] and stroke.”

In other words, in many cases readmitting patients to the hospital may actually be saving lives.

In their study, Daniel J. Brotman, M.D., and his colleagues concluded that “data on mortality and hospital readmission used by the United States Centers for Medicare and Medicaid (CMS) suggest a potentially problematic relationship.”

The findings from both these studies suggest that Medicare should reevaluate its penalization and reward system when it comes to readmission and mortality rates. Currently, the system is disproportionately balanced.

“Under the current policy, hospitals can lose up to three percent of condition-related payments from Medicare for excess readmissions, but can recoup only about 0.2% of such payments for having low mortality rates,” Medical Xpress reports.

Both these independent studies suggest that increasing rewards for hospitals with low mortality rates may create a better balance. At the moment, “the incentive to prevent death in the first 30 days after a hospitalization is 10 times less than the incentive to prevent a return hospital visit,” Scott Hummel, M.D., M.S., told Medical Xpress.

“It’s important that we continue to reduce preventable readmissions, but we need to watch out for unintended consequences too. Sometimes, a readmission might be a good thing — no one wants to see patients die because they should have been readmitted,” Hummel tells Medical Xpress.

Ultimately, it’s clear that Medicare must find a better balance when it comes to rewarding low readmission and low mortality rates — doing so could help save more lives while continuing to save the country billions of dollars.

What are your opinions on reducing post-hospital deaths and readmission rates in the U.S.? We’d love to hear your thoughts in the comments below.

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