Preventable Readmissions
Why We Want to Prevent Readmissions
Preventable hospital readmissions are a major part of unnecessary medical spending. The Center for Health Information and Analysis found that the estimated annual cost of this issue for Medicare is $26 billion, and $17 billion of that amount is considered avoidable. According to MedPAC, 75 percent of readmissions are preventable.
Recently, sepsis-related readmissions have become a focus area in readmission prevention work. Data shows that sepsis survivors have an increased risk of death, and analysis of New Jersey readmission data shows that patients readmitted with sepsis have increased rate of mortality.
Preventable readmissions indicate that there exist opportunities to improve our health care system to for discharged patients. This includes preventing patients from feeling confused about how to care for themselves at home after being discharged, helping them better understand discharge instructions and improving access to necessary follow-up care.
Success Within New Jersey Hospitals
Compared to baseline, New Jersey's hospitals have reduced preventable readmissions by 30 percent, avoided 66,032 potentially preventable readmissions and saved $581,608,171 in unnecessary healthcare costs.
Only one other state – Hawaii– outpaced New Jersey’s improvement in reducing readmissions between 2010 and 2015. This was a leading factor in the American Hospital Association selecting NJHA as a 2017 Dick Davidson Quality Milestone Award honoree.
NJHA and its members – both hospitals and post-acute care providers – have been engaged in a number of strategies to reduce hospital readmissions. This was accomplished in part through hospital participation in collaborative efforts:
- Beginning in 2007, the Robert Wood Johnson Foundation funded the NJHA Institute for Quality and Patient Safety to work with ten hospitals to improve care for minority patients with chronic heart failure as part of Expecting Success. Hospitals focused on gathering data on race and ethnicity of their patients and used that data to develop and implement a variety of care management tools and best practices, including Advance Practice Nurse-led care, patient educations work groups and post discharge follow-up activities.
- NJHA’s Collaborative to Reduce Readmissions, a two-year initiative launched in 2010. The collaborative brought together hospitals, nursing homes, home health and hospice providers in a joint effort to identify best practices, apply them to their organizations and share data to measure results. This work was the precursor to NJHA’s ongoing Partnership for Patients effort.
- Education programs and conferences in partnership with other healthcare stakeholders including Horizon Blue Cross Blue Shield of New Jersey and Healthcare Quality Strategies Inc.
- NJHA’s development of Well on Track, a web-based tool that helps hospitals organize and track follow-up with patients that are discharged from the hospital.
- New Jersey’s CARE Act, which defined processes for hospitals to work with patients, families and caregivers to ensure they have the information and support they need before being discharged from the hospital. NJHA worked collaboratively with policymakers to craft the bill and with AARP to promote implementation.
New Jersey HIIN Medicaid Readmission Collaborative
Reducing all-payer readmissions has been a long-standing focus of the NJHIIN work, and now with new Medicaid readmission non-payment policies in place, organizations need to be prepared to implement practices aimed at preventing readmissions in this patient population.
To improve processes aimed at reducing readmissions, Dr. Amy Boutwell, author of the ASPIRE readmission reduction model, is leading New Jersey organizations through the steps of this framework using discussion, coaching and workshop style learning.
Our Goals Moving Ahead
By September 2018, each participating NJHIIN hospital will reduce preventable readmissions by at least 12.5 percent.
Resources
NJHIIN Webinars
