Planned Readmissions: A Potential Solution

As a result of the Patient Protection and Affordable Care Act (hereinafter, “ACA”),¹ the Centers for Medicare and Medicaid Services (CMS) will be targeting avoidable readmissions to improve quality and reduce Medicare spending. In its Hospital Compare program, the CMS currently publishes hospital all-cause readmission rates after an initial admission for 1 of 3 diagnoses: acute myocardial infarction (MI), congestive heart failure, or pneumonia. The CMS will soon expand its readmission reporting to also compare hospital performance for all-cause 30-day readmission rates,¹ and it is estimated that these programs will save the Medicare program over $7 billion between 2010 and 2019.² The issue of avoidable readmissions has galvanized significant health care coordination efforts, and there have been several articles in the Archives recently focusing on such programs.^3-5