NCPA - National Center for Policy Analysis


July 28, 2009

The government spends an estimated $12 billion a year on "potentially preventable" readmissions for Medicare patients, according to the Medicare Payment Advisory Commission, an independent congressional agency.  U.S. leaders are trying to reduce such costs as they wrangle over how to retool the country's health care system.

Lawmakers agree on the need to drive down readmissions, but not on how to do it. Some patients aren't always willing, or able, to heed hospitals' advice.  The biggest sticking point may be this: it isn't in these institutions' financial interest to keep people from coming back, says the Wall Street Journal.

But hospitals are already under pressure.  Early this month, Medicare published 30-day readmission rates for heart attack, pneumonia and heart failure for every hospital in the country.  Nearly one in five patients discharged from the hospital is readmitted within 30 days.  For heart-failure patients, the rate is about one in four.

For such patients, there are ways to reduce round trips to the hospital, says the Journal:

  • According to the New England Journal of Medicine, 52 percent of Medicare patients readmitted within 30 days for heart failure hadn't seen a doctor since discharge, suggesting it is important to set and keep post-release appointments.
  • Sudden weight gain of even a few pounds can signal an impending decline -- one that can often be stemmed by tweaking medications or diet.
  • Attention to these issues can reduce readmission for heart failure by as much as 30 percent to 40 percent.

Moreover, some lawmakers want the government to help fund services like authorizing Medicare to pay for arranging follow-up care and training for recently discharged patients.  Others want to crack down on care providers that don't keep their readmissions in line. Even President Obama's proposed budget would penalize hospitals in the highest quartile of readmission rates for certain conditions, says the Journal.

Source: Ron Winslow and Jacob Goldstein, "Cutting Repeat Hospital Trips -- Simple Idea, Hard to Pull Off," Wall Street Journal, July 28, 2009.

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