Case Management

Faulty calculation method may penalize hospitals for readmissions progress

Case Management Insider, January 6, 2015

San Diego County hospitals are making big improvements in reducing their readmission rates, but that doesn’t mean they’re avoiding readmission penalties, according to a study by the Altarum Institute’s Center for Elder Care and Advanced Illness, with headquarters in Ann Arbor, Michigan.

The problem is a calculation quirk by Medicare, which determines whether an organization is making progress by dividing readmissions by the number of discharges at a given hospital, according to the report. The problem is that hospitals that are doing a good job not only reduce readmissions but their discharges also drop. This means that their ratio of readmissions to discharges stays the same, even when they’re making big progress. To improve fairness, Medicare should take a second look at how these numbers are figured, said Dr. Dr. Joanne Lynn, director of the Altarum Institute Center for Elder Care and Advanced Illness.

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