# What percentage of Medicare patients are readmitted to the hospital within 30 days of discharge for any reason?

## What percentage of Medicare patients are readmitted to the hospital within 30 days of discharge for any reason?

Historically, nearly 20% of all Medicare discharges had a readmission within 30 days. The Medicare Payment Advisory Commission (MedPAC) has estimated that 12% of readmissions are potentially avoidable. Preventing even 10% of these readmissions could save Medicare \$1 billion.

### What diagnosis has the highest 30-day readmission rate for Medicare patients?

With the exception of septicemia and heart failure, the principal diagnoses at index admission with high numbers of 30-day all-cause readmissions varied by expected payer. For Medicare patients, two respiratory system diseases—COPD and pneumonia—were among the five diagnoses with the highest number of readmissions.

#### How many readmissions occur within 90 days of discharge from hospitals?

Condition-specific 30- and 90-day readmission rates by post-acute discharge setting are presented in Table 1. For patients with stroke, 30-day readmission rates ranged from 8.8% in HHAs (ischemic) to 14.4% in SNFs (hemorrhagic) and 90-day rates ranged from 18.2% in HHAs (ischemic) to 26.1% in SNFs (hemorrhagic).

Readmission to acute hospital diagnoses The most common reasons for readmission for patients readmitted within 30 days were chest infection (n = 20), stroke (n = 14) and falls/immobility (n = 13).

What is the CMS penalty for readmission?

For the readmission penalties, Medicare cuts as much as 3 percent for each patient, although the average is generally much lower. The patient safety penalties cost hospitals 1 percent of Medicare payments over the federal fiscal year, which runs from October through September.

## What is CMS readmission rate?

The most recent data available show 14.9% (2019).

### How is CMS readmission rate calculated?

The Observed Readmission Rate is the percentage of acute inpatient stays during the measurement year that were followed by an unplanned acute readmission for any diagnosis within 30 days. It is equal to the Count of 30-Day Readmissions (Column 2) divided by the Count of Index Hospital Stays (Column 1).

#### What is CMS conditions of participation?

CMS develops Conditions of Participation (CoPs) and Conditions for Coverage (CfCs) that health care organizations must meet in order to begin and continue participating in the Medicare and Medicaid programs.

Is COPD a target condition for excess hospital readmissions?

In October 2014, COPD became a target condition for which hospitals were penalized for excess readmissions. The appropriateness, utility, and potential unintended consequences of the metric have been a topic of debate since it was first enacted.

What is a hospital-wide 30-day readmission?

2.1 Overview We developed a hospital-wide 30-day readmission measure. This measure reports the hospital-level, risk-standardized rate of unplanned all-cause readmission after admission for any condition within 30 days of hospital discharge.

## Do COPD care bundles reduce system-level failures and readmissions?

Zafar M.A., Panos R.J., Ko J. Reliable adherence to a COPD care bundle mitigates system-level failures and reduces COPD readmissions: a system redesign using improvement science. BMJ Qual Saf. 2017;26(11):908–918.

### Can predictive models predict COPD survival and readmissions?

Since the addition of the COPD condition to the HRRP, several predictive models have been developed to predict COPD survival and readmissions, with the intention of identifying modifiable risk factors. A number of interventions have also been studied, with mixed results.

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