Report: Hospitals reducing readmissions
A new report by Pennsylvania Health Care Cost Containment Council shows hospitals are making progress in lowering their readmission rates for four common conditions the organization tracked over a recent 20-month period.
According to a news release from PHC4, it examined hospital discharges from Jan. 1, 2013, through Aug. 31, 2014, including 30-day readmission ratings for the same condition and the average hospital charges of these readmissions. The conditions examined were abnormal heartbeat, chronic obstructive pulmonary disease, congestive heart failure and diabetes-medical management.
The report also includes county-level rates and statewide data on Medicare and Medicaid payments.
The improvement in readmission rates at hospitals in Washington and Greene counties was reflected in all but one condition at one hospital.
“The report shows a significant decline in readmission rates for the same condition since 2008 for COPD and since 2010 for CHF,” said Joe Martin, PHC4’s executive director. “That rates are dropping in these two chronic illness categories is a very positive sign, as preventable readmissions are a significant cost driver.”
Shedding some light on the impact these readmissions have on health care resources, the report notes that, for these four conditions alone, there were 13,525 readmissions for the same condition within 30 days, amounting to nearly 61,000 hospital days.
From a financial perspective, PHC4 looked at payment data from the two-year period 2011-2012 – the most recent payment data available for the study. Results showed readmissions for the same condition amounted to more than $62 million for Medicare fee-for-service and nearly $22 million for Medicaid fee-for-service and managed care for that period. For patients not covered by one of these payer types, the report estimates another $77 million in payments during 2011-2012.
Looking at other statewide trends over time, there were no significant changes in the rates of readmission for the same condition for abnormal heartbeat or the medical management of diabetes. Regionally, there was a significant decline in readmission rates for COPD in Western Pennsylvania since 2008 and declines in each region (Western Pa., central & northeastern Pa. and southeastern Pa.) since 2010 for CHF. Central & northeastern regions saw a significant increase in these readmission rates since 2008 for medical management of diabetes.
“This report points out the value of continued transparency of health care outcomes,” said Martin. “Ongoing examination of trends across time and the resources spent on these types of readmissions will be an important strategy going forward.”
The study included four area hospitals: Canonsburg Hospital, Monongahela Valley Hospital and Washington Hospital in Washington County and Southwest Regional Medical Center in Greene County.
As noted by PHC4, Washington and Greene County were below the Pennsylvania rate of 3.6 percent for readmissions at an average readmission charge of $23,100 for abnormal heartbeat, with Greene at 1.4 percent and Washington at 2.7 percent.
Specifically, Canonsburg had 123 readmissions for abnormal heartbeat, noting that the rate was not significantly different than expected. The number of cases was insufficient to report the readmission charge. MVH recorded 324 cases, which was significantly lower than expected (no average cost reported); while Washington Hospital had 751 readmissions for abnormal heartbeat, again with a rate that was not significantly different than expected, with an average cost of readmission of $17,038.
Southwest Regional’s readmission for the condition stood at 62, a number that did not require a reporting of an average charge for readmission.
However, for readmissions for treatment of congestive heart failure, Washington County’s 8.8 percent rate was 1.1 percent above the Pennsylvania average of 7.7 percent, while Greene’s was 7.1 percent. The statewide average charge for CHF was $35,589.
At Canonsburg, there were 182 readmissions at an average charge of $14,716; MVH, 463 ($20,956); Washington, 787 ($15,437); and Southwest Regional, 134 (NR).
Both counties were below the statewide average of 7.7 percent for readmissions for COPD, where the statewide average charge for readmission was $31,568, with Washington at 7.1 percent and Greene, 3.9 percent.
For COPD readmissions, Canonsburg had 238 with an average charge of $19,646; MVH, 490 ($16,861); Washington, 525 ($13,607); and Southwest Regional, 220 ($8,872).
The two counties fell below the statewide readmission average of 8.4 percent when it came to medical management of diabetes (average statewide readmission charge of $28,072), with Washington County at 7.1 percent and Greene at 3.1 percent.
At the individual local hospitals, Canonsburg reported 49 readmissions (no rate reported); MVH, 113 (NR); Washington, 240 ($14,918); and Southwest Regional, 50 (NR).
PHC4 is an independent state agency charged with collecting, analyzing and reporting information that can be used to improve the quality and restrain the cost of health care in Pennsylvania.