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October 26, 2011

Hospital Readmissions and the Affordable Care Act: Paying for Coordinated Quality Care

Author Affiliations

Author Affiliations: Brookings Institution, Washington, DC (Dr Kocher); and Warren Alpert Medical School, Brown University, Providence, Rhode Island (Dr Adashi).

JAMA. 2011;306(16):1794-1795. doi:10.1001/jama.2011.1561

Hospital readmissions have been the subject of ever-increasing scrutiny. Indeed, they are an important focus of the US Patient Protection and Affordable Care Act (ACA). Identified by the Medicare Payment Advisory Commission as a major action item for some time, hospital readmissions remain prevalent, costly, and largely preventable.1 The recently updated Hospital Compare Web site reveals that the national 30-day readmission rates for acute myocardial infarction (AMI), heart failure, and pneumonia have had limited if any improvement from 2007 through 2010.2 “Payment incentives to avoid readmissions” have been cited in the Department of Health and Human Services' strategic plan for 2010 through 2015 as an example of quality of care improvement.3 Hospital readmissions also have been singled out for improvement by the Centers for Medicare & Medicaid Services' (CMS’s) National Strategy for Quality Improvement in Health Care.4 The goal of the CMS's strategy is to effect a 20% reduction in hospital readmission rates by the end of 2013, thereby potentially preventing 1.6 million hospitalizations and saving an estimated $15 billion.4 We describe the various strategies embedded in the ACA that focus on this important challenge.

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