Readmission costs even higher than suspected

Systemic reforms needed

 

WASHINGTON – A new study on the cost of hospital readmissions finds that about 1 in 12 adults discharged from a hospital is readmitted within 30 days, adding $16 billion to the cost of healthcare in the United States, and, according to analysts, it underscores the need for a comprehensive approach to reforms.

The study, authored by Anna Sommers and Peter J. Cunningham for the National Institute for Health Care Reform, said the costs of readmission grow to $97 billion annually when including those patients readmitted within one year.

The costs have caught the attention of policy makers, as Medicare prepares to penalize hospitals deemed to have high rates of avoidable readmissions. The move, which private insurers are also considering, is intended to push hospitals to better ensure patients get the care they need after they are released.

But, the study finds, readmissions are not brought on simply by a lack of follow-up care for a recurring heart ailment or a fractured hip not healing properly.

“Many of the conditions for which adults are readmitted are not related to the first hospitalization,” Sommers noted. “One-quarter of all readmissions within 30 days (are) unrelated by condition. Almost 40 percent of (readmissions) out to one year after discharge are unrelated. When hospitals and health plans focus on preventing readmissions for just one condition, an opportunity to lower costs is missed.”

Nancy Foster of the American Hospital Association said hospitals are working on ways to better communicate with patients and to work more closely with healthcare providers in patients’ communities. But those initiatives assume a next level of care. As the study documents, most readmitted patients either don’t access proper follow-up care, or they don’t have access to it.

“There’s a system flaw here,” Foster said.” We need to think more broadly about how we can fill this gap.”

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