Case study reducing 30 day readmissions

Case study reducing 30 day readmissions

Hospitals publicly report their rates of readmission within 30 days of hospital discharge to CMS and accrediting agencies such as the Joint Commission. If a hospital’s readmission rate exceeds the established threshold, this can result in a decrease in reimbursement for Medicare patients, which negatively affects the hospital’s financial performance.

Conduct a search for hospitals or health systems that publish their data about readmissions within 30 days of discharge; then, identify which of those mention the steps they have taken or the plans they have implemented to address the issue.

Write a 2 paper (in APA format) that discusses the following points:

  1. The reasons that contribute to patients being readmitted to the hospital. Mention utilization or quality data that was used to help identify contributing factors.
  2. The actions that the facility or system took to reduce readmission rates. Include the methodology used (if mentioned), such as case management or process improvement.
  3. The effectiveness of the actions taken (did it lead to a decrease in readmissions)
Requirements
Discuss the reasons that contribute to patients being readmitted to the hospital. (Mention utilization or quality data that was used to help identify contributing factors.)
Describe the actions that the facility or system took to reduce readmission rates. Include the methodology used, such as case management or process improvement.
Explain the effectiveness of the actions taken (did it lead to a decrease in readmissions)
2-3 pages, in APA format, free of spelling, grammar, and punctuation errors.

 

 

Healthcare organizations must be able to drive quality from the inside by setting goals and standards that can be similar to the external drivers you learned about in previously.  Among those internal guidelines and standards are processes including utilization management, case management and disease management. All three are designed to reduce the costs associated with waste and/or abuse, control costs and achieve better patient outcomes.

The Written Assignment deals with 30-day readmissions, which is used as a quality measure. You may remember that this measure is used by CMS (Medicare and Medicaid). It looks at patients who are readmitted to the hospital within 30 days of an inpatient discharge for the same or similar condition. Study the measure definition by using the Hospital Compare website at https://www.medicare.gov/hospitalcompare/Data/30-day-measures.html. Your papers should include:

  • A discussion of the reasons patients are being readmitted to the hospital
  • The actions taken to reduce readmissions
  • The effectiveness of the actions taken

Take some time to research case management and disease management programs and think about the reasons physicians resist their use for the Discussion Question thread. Some of the reasons may surprise you.

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