Noteworthy News

Feds Issue Guidance on Reducing Medicare Readmissions

cmsThe Centers for Medicare & Medicaid Services has issued a new report advising hospitals how to reduce readmissions among their racially and ethnically diverse Medicare patients.

According to a CMS news release, the guidance

…is designed to assist hospital leaders and stakeholders focused on quality, safety, and care redesign in identifying root causes and solutions for preventing avoidable readmissions among racially and ethnically diverse Medicare beneficiaries.

The guidance also notes that

Racial and ethnic minority populations are more likely than their white counterparts to be readmitted within 30 days of discharge for certain chronic conditions, such as heart failure, heart attack, and pneumonia, among others. Social, cultural, and linguistic barriers contribute to these higher readmission rates.

The document presents an overview of issues affecting readmissions and offers what it calls “high level recommendations” for hospital officials to “move the needle” on those readmissions. Those recommendations:

  • Create a stronger radar.
  • Identify the root causes.
  • Start from the start.
  • Deploy a team.
  • Consider systems and social determinants
  • Focus on culturally competent, communication-sensitive, high-risk scenarios.
  • Foster community partnerships to promote continuity of care.

According to the report,

Some studies have shown that certain patient-level factors, such as race, ethnicity, language proficiency, age, socioeconomic status, place of residence, and disability, among others—when tied to particular costly and complicated medical conditions such as heart failure, pneumonia, and acute myocardial infarction, to name a few—may be predictors of readmission risk and readmissions. In fact, research has demonstrated—and evaluations of the HRRP to date have found—that minority and other vulnerable populations are more likely to be readmitted within 30 days of discharge for chronic conditions, such as congestive heart failure, than their white counterparts. Given the cost and quality implications of these findings, addressing readmissions while caring for an increasingly diverse population has become a significant concern for hospitals and hospital leaders. In sum, there is a need for additional guidance on how hospitals can focus both system-wide redesign as well as targeted and specific efforts at preventing readmissions among minority and vulnerable populations. 

NAUH has long been among the leaders in calling to policy-makers’ attention the special challenges posed by socio-economically disadvantaged patients and the potential unfairness of Medicare payment policies that fail to reflect challenges. Among other activities in support of this view, NAUH endorsed legislation last year to require Medicare to add a risk-adjustment component to its Hospital Readmissions Reduction Program; see NAUH’s message to Congress on this issue here.

To learn more about the new CMS document Guide to Preventing Readmissions Among Racially and Ethnically Diverse Medicare Beneficiaries, go here to read a CMS news release on its report and find the report itself here.

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