Readmissions are falling fast thanks to the hard work of America’s hospitals to improve care, provide better discharge instructions to patients and partner with patients and others in their communities to coordinate care after they leave the hospital (Medicare Rules Reshape Hospital Readmissions, December 2). However, the Wall Street Journal’s analysis questions that these gains have been fully achieved. 

Here is what the numbers show. Between January 2012 and November 2014, hospitals participating in the American Hospital Association Partnership for Patients initiative avoided 65,022 readmissions generating health care savings of nearly $575 million. Additionally, an analysis in a 2014 CMS peer-reviewed journal did not find evidence to suggest the drop in readmissions rates was the result of increases in either emergency department visits or observation stays as CMS stated in the article.

It is no coincidence that the increase in observation services occurred with the advent of the Recovery Audit Contractors (RAC) program.  Too often, the medical judgment of treating physicians was second-guessed by RACs, which could evaluate a beneficiary’s admission in hindsight, looking at the entire medical record rather than only the information that was known to the physician at the time of the admission. Fortunately, CMS has moved to curtail the egregious behavior of the RACs. 

However, there is always more work to be done but the Centers for Medicare and Medicaid Services (CMS) own data show we are headed in the right direction.  That’s good news for patients.

Related News Articles

Headline
An estimated 23 percent of outpatient antibiotic prescriptions filled by privately insured children and non-elderly adults in the United States in 2016 were…
Insights and Analysis
Also in this weekly roundup of health-related news: treatment options scarce as meth deaths flare; app makes donating blood easier
Headline
Hospitals and health systems may apply through Feb. 19 for the 2019 AHA Equity of Care Award, which recognizes organizations participating in the AHA's #…
Insights and Analysis
At last month’s AHA Executive Forum, Kimberlydawn Wisdom, M.D., senior vice president of community health and equity and chief wellness and diversity officer…
Headline
The AHA today submitted to the Food and Drug Administration legislative, regulatory and best practice recommendations to address new and chronic prescription…
Headline
A coalition of 40 health care and public health organizations, including the AHA, today urged the Senate to quickly pass the Pandemic and All-Hazards…