Data shows ACA reforms leading to lower hospital readmission rates for Medicare beneficiaries

[ProSense]

New Data Shows Affordable Care Act Reforms Are Leading to Lower Hospital Readmission Rates for Medicare Beneficiaries

December 6

Being re-hospitalized shortly after being discharged is an unpleasant experience for patients. It’s also costly for patients, insurance companies and other payers, and—if the patient is a Medicare beneficiary—taxpayers, too. High readmission rates – the percentage of inpatient discharges where a re-hospitalization occurred – can also be a sign of low-quality care. It often means there may have been unclear instructions to patients or lack of follow-up care.

While many people only understand the Affordable Care Act as a plan to expand health insurance, it includes many provisions to slow the growth in health costs. Why does this matter? The consistent increase in health care costs over the past several decades puts a strain on the national pocketbook and that of millions of families who faced rapidly increasing premiums.

And we’re seeing results. Health care price inflation is now at its lowest level in 50 years, and, according to the most recent projections, health care spending grew at the slowest rate on record over the last three years. Real per person spending grew at just a 1.3 percent rate, and this slow growth was seen in Medicare, Medicaid and private insurance. Inflation for health care goods and services is currently running at just 1 percent on a year-over-year basis.

As just one of the many reforms to slow health care costs and improve patient quality, over the past several years the Centers for Medicare & Medicaid Services (CMS) and others have focused on reducing avoidable readmissions, including hospital-level improvement initiatives, community-based care transitions programs, and broad-based payment incentives like the Hospital Readmissions Reduction Program.

The all-cause 30-day hospital readmission rate among Medicare fee-for-service beneficiaries held constant from 2007 to 2011. Earlier this year, a group of researchers at CMS published a study revealing good news about hospital readmissions: In 2012, when the Affordable Care Act’s reforms focused on reducing avoidable readmissions kicked in, this rate began to fall. After holding steady at 19 percent from 2007 to 2011 the all-cause 30-day hospital readmission rate among Medicare fee-for-service beneficiaries fell to 18.5 percent in 2012.

We are pleased to report that the decline in readmission rates is continuing into 2013. Preliminary claims data shows the Medicare readmission rate averaged less than 18 percent over the first eight months of 2013. This translates into an estimated 130,000 fewer hospital readmissions between January 2012 and August 2013.



In addition, this trend is widespread across the country. To see how rates are changing at the local level, we compared readmission rates over the first eight months of 2013 to the average rates for 2007-2011 in local health care markets. We found that this year’s readmission rates were at least a half a percentage point lower in 76 percent of local markets (232 of the 306). Fewer than 10 percent of local markets had higher rates. Using the same comparison, readmission rates also went down in 49 states and the District of Columbia. The only state that did not see a decrease – Utah – already had one of the lowest readmission rates in the country.



We can see that the decline in all-cause readmission rates that began in 2012 is continuing this year on a widespread basis. While we continue to monitor and study these encouraging reductions, what is clear is that intense focus on reducing hospital re-admissions through improved processes of care and new tools in the Affordable Care Act are having a demonstrably positive impact.

http://blog.cms.gov/2013/12/06/new-data-shows-affordable-care-act-reforms-are-leading-to-lower-hospital-readmission-rates-for-medicare-beneficiaries/

This is the stuff that doesn't get reported.

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http://www.democraticunderground.com/10024763477

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http://www.democraticunderground.com/10024755799

The Revolution Will Not Be Televised - The Obamacare Photos the MSM Doesn't Want You to See
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[shraby]

1. One reason for the readmissions isn't spoken about. Medicare will only pay for x number

of day, but if a patient is still seriously sick, a doctor would check the patient out of the hospital then readmit them to continue their care under medicare.

[ProSense]

2. You can see

"One reason for the readmissions isn't spoken about. Medicare will only pay for x number of day, but if a patient is still seriously sick, a doctor would check the patient out of the hospital then readmit them to continue their care under medicare."

...how that can lead to fraud. The ACA also improved access to long-term home health care (http://www.democraticunderground.com/10024695694) via Medicaid.

Still, the mandate is for hospitals to provide better care.

Hospitals chart ways to boost care, funding under ACA

Alicia McElhaney

Patient satisfaction is high on the checklist.

Hospitals are getting creative when it comes to meeting tough new mandates in the Affordable Care Act to improve care and increase patient satisfaction...Under an ACA program, the federal government gives money to hospitals that deliver better care, rather than just paying them for procedures covered by Medicare and Medicaid. Called the Hospital Value-Based Purchasing program, it aims to increase quality care and shrink the number of patients who die from mistakes.

As part of the program, the Center for Medicare and Medicaid Services (CMS) pays hospitals for infection prevention, successful surgeries, low readmission rates and patient satisfaction scores. The CMS bases funding on both achievement and yearly improvement.

Hospitals across the country are taking steps to improve and claim the extra funds.

<...>

Every year, 210,000 to 440,000 people die from avoidable hospital mistakes, according to a 2013 study published in the Journal of Patient Safety...mistakes cost the health care system nearly $7.3 billion in two years, according to a 2013 study by quality awareness company HealthGrades.

- more -

http://www.usatoday.com/story/news/nation/2014/03/27/hospitals-improve-care-funding-creatively/5899835/

[ProSense]

3. Kick! n/t

[Bill USA]

4. great post. haven't been on much here at DU lately. Recommended, bookmarked

good info to have to counter anti-ACA propaganda.