Dartmouth Atlas report shows little improvement in readmissions

In the National Journal, Maggie Fox explains a new Dartmouth Atlas Project report (PDF) which demonstrates that, despite the looming implementation of penalties included in the Affordable Care Act and the existence of a simple, proven road map to improvement, most hospitals haven’t significantly cut down their readmission rates over the better part of the past decade.dartmouth-readmissions

“Only seven of the 94 academic medical centers we studied had statistically significant changes in 30-day readmission rates following medical discharge from 2004 to 2009,” [Dr. David Goodman’s] team wrote.

According to Goodman, improving readmission rates is a simple matter of actively scheduling follow-up visits and implementing a team approach to care delivery. Unfortunately, he told Fox, making that work in a busy hospital appears to be easier said than done, even with significant federal penalties lurking just over the horizon.

The 2010 health-care reform law begins using a stick in one year, penalizing hospitals with higher-than-expected readmission rates for Medicare patients treated for heart failure, heart attack or pneumonia. Medicare payments could be cut by up to 1 percent in October 2012, 2 percent in 2013 and 3 percent in 2014.

In addition to the overall message of the report, it’s interesting to note that readmission rates were affected by the same regional variation which has provided such fertile ground for reporters covering other Dartmouth Atlas Project research.

The percent of patients landing back in the emergency room within 30 days of discharge after surgery varied from less than 12 percent in 2009 in Rapid City, South Dakota, to 19 percent in Kingsport, Tennessee and 18 percent in Newport, Rhode Island.

For an example of how to localize the information in the report, see this article by Stacey Singer in The Palm Beach Post. To learn more about readmission data from CMS, see this article by Charles Ornstein, AHCJ president and ProPublica senior reporter.

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