An Opportunity to Improve Medicare's Planned Readmissions Measure.
J Hosp Med
; 12(10): 840-842, 2017 10.
Article
en En
| MEDLINE
| ID: mdl-28991951
ABSTRACT
In the Hospital Readmission Reduction Program (HRRP), the Centers for Medicare & Medicaid Services (CMS) utilizes a planned/unplanned algorithm to prevent hospitals from being penalized for scheduled rehospitalizations. We evaluated version 3.0 of the CMS planned readmission algorithm and hypothesized that some readmissions categorized as planned by the HRRP algorithm may actually be unplanned. We identified 143,054 index admissions and 16,116 thirty- day readmissions for 131 hospitals. Only 1252 readmissions were considered planned according to Medicare's readmission algorithm. The majority of these planned readmissions (723 [57.8%]) had an "emergent" or "urgent" admission type listed on the readmission claim, and many (513 [41.0%]) had emergency department charges, suggesting unanticipated returns to the hospital. HRRP should consider using the admission type variable and/or the presence of emergency department charges as a source of information when determining whether a readmission is planned or unplanned.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Readmisión del Paciente
/
Medicare
/
Indicadores de Calidad de la Atención de Salud
Tipo de estudio:
Prognostic_studies
Límite:
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
J Hosp Med
Año:
2017
Tipo del documento:
Article
País de afiliación:
Estados Unidos