What is the purpose of the CMS readmission reduction program?
The Hospital Readmissions Reduction Program (HRRP) is a Medicare value-based purchasing program that encourages hospitals to improve communication and care coordination to better engage patients and caregivers in discharge plans and, in turn, reduce avoidable readmissions.
What is the 30 day readmission rule?
CMS defines a hospital readmission as “an admission to an acute care hospital within 30 days of discharge from the same or another acute care hospital.” It uses an “all-cause” definition, meaning that the cause of the readmission does not need to be related to the cause of the initial hospitalization.
Why was the Hrrp created?
In order to provide direct financial incentive to hospitals participating in the IPPS to reduce readmission rates, the ACA added section 1886(q) to the Social Security Act establishing the HRRP. Additionally, hospitals must have at least 25 initial hospitalizations for a diagnosis to be measured.
Why is Hrrp important?
Why is the Hospital Readmissions Reduction Program important? HRRP improves Americans’ health care by linking payment to the quality of hospital care. CMS incentivizes hospitals to improve communication and care coordination efforts to better engage patients and caregivers on post-discharge planning.
Is Hrrp successful?
The HRRP not only demonstrated significant reductions in readmission rates for the targeted medical conditions but also had a notable spillover effect to nontargeted conditions,2 including surgical procedures.
Does Medicare penalize hospitals for readmissions?
For the readmission penalties, Medicare cuts as much as 3 percent for each patient, although the average is generally much lower. The patient safety penalties cost hospitals 1 percent of Medicare payments over the federal fiscal year, which runs from October through September.
What percent of readmissions are avoidable?
New Study Finds 27% of 30-Day Hospital Readmissions Are Preventable. A recent University of California San Francisco (UCSF) study published in JAMA Internal Medicine reports that over one quarter of all 30-day hospital readmissions are preventable.
Does the Hrrp work?
The robustness checks by DDD do not necessarily confirm the strong effects of the HRRP across hospital and patient groups. However, they confirm significant effects of the HRRP on reducing Medicare AMI readmissions in low-income hospitals and hospitals that treat a high percentage of Medicaid patients.
What are hospitals doing to reduce readmissions?
For patients discharged to post-acute care facilities, multicomponent interventions have reduced readmissions through enhanced communication, medication safety, advanced care planning, and enhanced training to manage common medical conditions that commonly precipitate readmission.
How hospitals are reimbursed?
Hospitals are paid based on diagnosis-related groups (DRG) that represent fixed amounts for each hospital stay. Increasingly, healthcare reimbursement is shifting toward value-based models in which physicians and hospitals are paid based on the quality—not volume—of services rendered.
Can CMS shut down a hospital?
CMS has the legal authority to terminate a hospital’s Medicare agreement if it does not comply with one of more of the CoPs, but there is no statutory authority to levy civil monetary penalties.
How can technology help reduce readmissions?
Use readmission risk assessment to apply resources to most appropriate patients;
How can patient education help to reduce readmission?
Reducing readmission risk.
How can clinical pathways reduce readmissions?
Ensure Adequate Nursing Coverage. One key to lowering readmission rates is to ensure that you have appropriate nurse staffing levels.
How to reduce readmission?
1. Understand which patient populations are at greatest risk of readmissions. It is critical hospitals identify which patient populations are at