Readmissions (2). What are the experiences that are yielding results?

The Congress Investigation Services of the US (CRS) published in September 2010, in support of the Obamacare, a report on charges for Medicare of hospital readmissions. The very well documented report assumes that 17.6% of discharge bills issued by hospitals to Medicare are due to the readmissions occurred within 30 days of discharge. Therefore, the two economists who signed the report assumed that they found in the readmissions a source for collecting Medicare savings, moreover taking into account that the variations between areas were making it possible to foresee that an adjustment in the contracting model could be fruitful.

From this document I liked the classification of the actions aimed at reducing readmissions, actions that as it will be seen to be effective, must be tailored to the complexity of the elected patients.

Model 1: very complex patient, intensive action

Readmissions (1): what are the best policies to reduce them?

To create this readmissions post, I have chosen three publications, the first of which provides a critical review of how the American public insurers address the issue, the second publication gives the point of view, also critical, of two hospital doctors, whilst the third is a review promoted by "The Commonwealth Fund" on the policies of US hospitals that are having the lowest rates of readmissions nationwide.

First publication

According to this article, CMS (the public body that manages the Medicare and Medicaid contracts in the US) estimates the average for the 30-day readmissions rates for patients who have been hospitalized for myocardial infarction, pneumonia and heart failure. If a hospital’s rates go above the average, CMS penalizes it with a reduction in the fees of all income in the following year, in proportion to the deviation of readmissions of the three monitored conditions. It’s estimated that in 2013, in a particular centre, the punishment can reach up to 3% of the turnover. Ah! And there will be no prize for hospitals with rates lower than the average.