There has been concern that hospitals may put resources and effort into preventing readmissions only to see their discharged patients dying, and that hospitals with more liberal readmission practices might be preventing death.
Researchers failed to find any evidence of a relationship for heart attack or pneumonia, and for heart failure, "only a modest and not throughout the entire range of performance" relationship was identified, Krumholz and colleagues wrote.
If anyone thought CMS or its readmissions policy consultants were going to come out and say, 'hey, we didn't carefully think these policies through the first time and we were wrong,' there's a bridge I know that's for sale.
Finally, the Robert Wood Johnson Foundation had a special webinar this week on preventing readmissions. It featured top experts in policy including Jonathan Blum of CMS; Eric Coleman, MD, who designed the Coleman model of care transitions, Mary Naylor of the University of Pennsylvania School of Nursing, and Risa Lavizzo-Mourey, MD, RWJF's President and CEO.
The audience heard numerous stories of interventions as part of RWJF's Care About Your Care campaign.
The urgency around reducing readmissions is real, and the reason is dollars.
For the fiscal year that began Oct. 1, 2012, when the readmission penalty can not exceed 1% of a hospital's base DRG, CMS estimated it expects to ding hospitals about .3% or about $280 million. Starting this Oct. 1, if my math is correct, that amount would double, and by Oct. 1, 2014, when the full 3% penalty kicks in, the penalty might be $840 million.
As the saying goes: A few hundred million here and a few hundred million there—it starts to add up. Now we're talking real money.