Hospital Readmissions

The Centers for Medicare and Medicaid Services have taken on initiatives to improve quality of care for Medicare patients since the Affordable Care Act was passed in 2010. In 2012 CMS implemented a program called The Hospital Readmissions Reduction Program (HRR), this program is intended to improve health care for patients with Medicare to improve the quality of care that is provided versus the quantity of care. This program provides incentives to hospitals, which is intended to reduce costly and unnecessary readmissions (Centers for Medicare and Medicaid Services, 2016). The conditions that are currently being monitored by CMS for readmissions are heart attack, heat failure, and pneumonia. If hospitals have a high percentage of readmissions
This review by the NQF is getting full attention from members of congress and there is a bill S. 2501, which is the “Hospital Readmissions Program Accuracy and Accountability Act”, which calls upon the Department of Health and Human Services to include socioeconomic status to the risk adjustment formula in 2017. There have been many studies conducted that have founded that the SES factors are largely related to patients being readmitted to hospitals after
Items to ensure that is within their policies are education to patients about how to use their medications properly, that patients have their follow up appointments scheduled prior to discharge or at minimum knows when to get the appointment scheduled and knows who to call, they should also ensure their providers information is included in their discharge papers, and during discharge all follow up care discussed with the patient. There should be a quality model such as PDSA adopted for HRRP to help safety net hospitals and other hospitals to identify where they need to make improvements and adjust policies and procedures according to their findings to ensure they are meeting the goals set forth by congress and