Many of the ACA Quality-Enhancing Ideas Have Previously Failed
One of the many pilot projects of health reform is to reduce the number of readmissions within 30 days of Medicare patients discharged from a hospital. The problem: it’s already been tried by the VA Health Administration and failed to lower the number of readmissions, according to a report in The Washington Post.
The Veterans Health Administration, the largest integrated health care system in the country, has long employed many of the approaches Medicare is pushing on all hospitals to reduce unnecessary readmissions. But new data show VA hospital patients are just as likely to end up back in a hospital bed as are patients at private hospitals. The new statistics underscore how hard it may be for hospitals to stop patients from rebounding back through their doors, a major goal of Medicare as it seeks to curtail the nation’s ballooning health costs.
CMS desperately wants to reduce readmissions. However, it may not be able to. Hospitals have an incentive to discharge patients because the capitated payments (DRGs) do not reimburse for longer than average stays. This may contribute to readmissions. One solution may be like is done by Geisinger, where they provide a warranty in return for higher reimbursements. CMS could boost the payment and make it a package that includes all readmissions within 30 days.
This is a very tricky stat. I have looked at recidivism rates for research, and it’s not easy to determine readmission causes and find all locations of admissions
I agree with Devon. This is one of CMS’s major problems. Anyone with a solution to hospital readmission rates is going to make billions. But, the system is set up for failure because of the incentives created by reimbursement rates.