What is the clinical evidence from this study?

Study design: Observational. Population: Excess hospital readmissions (AMI, HF, COPD, PN, THA/TKA) (n=2465). Intervention: Readmission reduction program vs. Status quo (no additional readmission reduction). Primary outcome: Medicare reimbursement gains per avoided readmission.

August 24, 2018Medical Care Research and ReviewOpen Access

Does a Reduction in Readmissions Result in Net Savings for Most Hospitals? An Examination of Medicare’s Hospital Readmissions Reduction Program

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Key result

Avoiding one excess readmission would result in reimbursement gains of $10,000 to $58,000 for Medicare discharges for an average hospital, providing a strong economic case for readmission reduction efforts.

Population

2,465 hospitals with excess readmissions for at least one of the applicable conditions in the Fiscal Year…

Design

Other

Authors

OYOlga YakushevaBloomberg (United States)GHGeoffrey J. HoffmanUniversity of Michigan

Discussion

Member takes

Implication

May justify readmission reduction investments for penalized hospitals; leaves open whether gains exceed program costs.

Study Design

Type

Observational (n=2,465)

Structured PICO

Population

2,465 US hospitals with excess readmissions for at least one of five applicable conditions under Medicare's Hospital Readmissions Reduction Program in FY 2016.

Intervention

Pro forma analysis of investment in a broad-scale readmission reduction program (assuming 5% and 10% reductions in readmissions and per-discharge costs of $130 to $325).

Outcome

Impact of an incremental reduction in excess readmissions on a hospital's Medicare reimbursement revenue and expected net earnings from investing in a readmission reduction program.

Investing in broad-scale readmission reduction programs presents a strong economic case for most hospitals penalized under Medicare's Hospital Readmissions Reduction Program, yielding net savings.

Limitations

Unable to adjust net earnings analyses for potential differences in condition-specific implementation costs or effectiveness
Did not examine potential economies of scale
Assumed that readmissions cost, and are reimbursed, at the same rate as an index Medicare discharge
Did not measure positive reputational effects and increased demand for hospital services
Penalty reductions are estimated for incremental changes in readmissions and may not be accurate for large readmission reductions
Derivative calculus methods can be inaccurate in predicting effects of large changes in the independent variable (readmissions) for non-linear functional forms.
Earlier studies used for cost estimates were published prior to the recently observed nationwide reduction in readmissions.
Lack of actual hospitalization cost data required estimating per-discharge costs using assumptions like a -5% patient revenue markup and an 80/20 direct-to-indirect cost breakdown.

Cite This Study

Yakusheva et al. (2018) conducted an observational in Excess hospital readmissions (AMI, HF, COPD, PN, THA/TKA) (n=2,465). Readmission reduction program vs. Status quo (no additional readmission reduction) was evaluated on Medicare reimbursement gains per avoided readmission. Avoiding one excess readmission would result in reimbursement gains of $10,000 to $58,000 for Medicare discharges for an average hospital, providing a strong economic case for readmission reduction efforts.

synapsesocial.com/papers/6a9c99519beff30feb5d374c https://doi.org/10.1177/1077558718795745

View Full Paper

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August 24, 2018Medical Care Research and ReviewOpen Access

Does a Reduction in Readmissions Result in Net Savings for Most Hospitals? An Examination of Medicare’s Hospital Readmissions Reduction Program

View Full Paper

Ask AI

Bookmark

Key result

Population

2,465 hospitals with excess readmissions for at least one of the applicable conditions in the Fiscal Year…

Design

Other

Authors

OYOlga YakushevaBloomberg (United States)GHGeoffrey J. HoffmanUniversity of Michigan

Discussion

Member takes

Implication

May justify readmission reduction investments for penalized hospitals; leaves open whether gains exceed program costs.

Study Design

Type

Observational (n=2,465)

Structured PICO

Population

2,465 US hospitals with excess readmissions for at least one of five applicable conditions under Medicare's Hospital Readmissions Reduction Program in FY 2016.

Intervention

Pro forma analysis of investment in a broad-scale readmission reduction program (assuming 5% and 10% reductions in readmissions and per-discharge costs of $130 to $325).

Outcome

Impact of an incremental reduction in excess readmissions on a hospital's Medicare reimbursement revenue and expected net earnings from investing in a readmission reduction program.

Investing in broad-scale readmission reduction programs presents a strong economic case for most hospitals penalized under Medicare's Hospital Readmissions Reduction Program, yielding net savings.

Limitations

Unable to adjust net earnings analyses for potential differences in condition-specific implementation costs or effectiveness
Did not examine potential economies of scale
Assumed that readmissions cost, and are reimbursed, at the same rate as an index Medicare discharge
Did not measure positive reputational effects and increased demand for hospital services
Penalty reductions are estimated for incremental changes in readmissions and may not be accurate for large readmission reductions
Derivative calculus methods can be inaccurate in predicting effects of large changes in the independent variable (readmissions) for non-linear functional forms.
Earlier studies used for cost estimates were published prior to the recently observed nationwide reduction in readmissions.
Lack of actual hospitalization cost data required estimating per-discharge costs using assumptions like a -5% patient revenue markup and an 80/20 direct-to-indirect cost breakdown.

Cite This Study

synapsesocial.com/papers/6a9c99519beff30feb5d374c https://doi.org/10.1177/1077558718795745

Also Consider

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