Each year, approximately 16 percent of patients in United States hospitals are readmitted within 30 days of discharge. Readmissions and the additional treatments they entail are costly to both patients and insurers. Increasingly, they are costly to hospitals as well.
A portion of readmissions are considered unavoidable, such as a planned readmission for chemotherapy, or an unexpected adverse event unrelated to the original diagnosis. However, many other readmissions are considered preventable through high quality clinical care and effective patient education and discharge procedures.
In an effort to reduce hospital readmission rates nationwide, the Centers for Medicare and Medicaid Services (CMS) has begun financially penalizing hospitals with higher than expected readmission rates. The cost of those penalties across United States hospitals has increased significantly from a total of $290 million in fiscal year (FY) 2013 to a total of $528 million in FY 2017.
More than half of the nation’s hospitals were affected by CMS penalties in FY 2017, and the average total penalty per hospital increased by about 20 percent from the previous year.
CMS’s steep penalties are motivated by a desire to provide better patient care and, in doing so, to reduce healthcare costs. One of the best ways hospitals can prevent unnecessary readmissions is by calling patients after their discharge to check in on symptoms, review medications and treatment plans, and offer patients an opportunity to ask questions about their recovery.