"It isn't just about understanding why the provider is making the right or wrong choices, but also figuring out how to ensure that high-quality decisions are being made. There's an unlimited opportunity in the market to affect performance and make the system more responsive," says Krumholz. "I saw the best opportunity to impact practice was to produce knowledge that could be immediately applied."
When Krumholz began his research on readmissions, there was no incentive in the industry to pay attention to the rates at which patients were returning to the hospital. Despite their findings, Krumholz and his team were searching for subjects and participants, but hospitals didn't adopt their initial findings "because there was no incentive to do it." Almost no hospitals that did participate in the readmissions pilot program continued.
"You only have to look closely at the lack of systems we have in place that truly help people make a transition to realize how broken this system is. Anyone who has been in the hospital knows that returning home is a rocky transition and usually little is done to help them," says Krumholz. "Readmission rates are starting to drop but it will take several years to replace a mind-set that's existed for decades."