Reducing Potentially-Preventable Readmissions in CAHS (FMT Policy Brief #43)

Publication Date: Mar 2016
Author(s): Distel E, Casey MM, Prasad S
Research Center(s): Minnesota
Project: Reducing Potentially-Preventable Readmissions in CAHs
Topic(s): MBQIP, Quality

Preventable hospital readmissions are considered to be a marker of poor-quality care and may reflect problems with care coordination. Additionally, they place a significant financial burden on the health care system. Since October 1, 2012, the Centers for Medicare & Medicaid Services (CMS) has penalized Prospective Payment System (PPS) hospitals with excess readmissions by reducing their Medicare payments under the Hospital Readmissions Reduction Program (HRRP) authorized by the Affordable Care Act. Currently, Critical Access Hospitals (CAHs) are exempt from these penalties; however, readmission rates are an area of focus in the Medicare Beneficiary Quality Improvement Project (MBQIP). It is important for CAHs to examine their readmission rates and consider implementing strategies to reduce potentially-preventable readmissions.

The purpose of this project is to identify and disseminate information about successful evidence-based interventions that have been conducted to reduce readmissions in CAHs and other small rural hospitals.

Key Findings:

  • It is important for CAHs to examine their readmission rates and consider implementing strategies to reduce potentially-preventable readmissions.
  • Several evidence-based readmission reduction programs that have been shown to reduce readmissions in large hospitals are being implemented in CAHs or show promise to be useful in small rural hospital settings.
  • Common readmission reduction strategies include increased time spent with patients and families at discharge to ensure that care management plans are understood and improving coordination with the patient’s primary care physician.
  • A number of readmission reduction programs have shared their resources and tools with other programs, and make them available online.

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