The Patient Protection and Affordable Care Act included a number of provisions aimed at curbing Medicare readmissions—seen as a marker of low-quality care—that cost an estimated $26 billion annually.
Experts said the new data underscore hospitals' increasing attention to the issue. “It's remarkable,” Dr. Brian Jack, chair of Boston University's department of family medicine, who led the creation of an intervention known as Re-Engineered Discharge that's used in hundreds of hospitals. He attributed the drop in readmissions at least partly to a growing understanding that keeping patients out of the hospital requires a multipronged approach involving hospitals, primary-care physicians, family caregivers and community-based groups.
Dr. Mark Williams, chief of hospital medicine at Northwestern Memorial Hospital, Chicago, questioned whether the rise in observation stays had affected the data. “We need to see the data,” said Williams, who heads an effort targeting care transitions and readmissions.
Dr. Eric Coleman, director of the widely adopted Care Transitions Program at the University of Colorado Denver, said this latest round of data shows the “trends in reduction are real.” Coleman said ACA-established penalties for readmissions may have grabbed hospitals' attention. But the real improvement was driven by collaboration among quality-improvement organizations, hospital associations, providers and other groups.
“Will rates continue to improve or will they flatten out?” he said. “Was there low-hanging fruit that hospitals went for right away? The next set of data points will show us if the effect is sustainable.”
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