Healthcare News & Insights

Study: Hospitals serving poor, older patients have higher readmissions rates

If your hospital serves a large proportion of poor, older patients, you may be unfairly targeted by new readmissions penalties.

162441921As the Centers for Medicare & Medicaid Services (CMS) continues ramping up the penalties it doles out to hospitals with high readmissions rates, a new study published in the Health Services Research medical journal suggests age and socioeconomic status may keep some figures out of hospitals’ control.

The results of the study were detailed in an article from MedicalXpress.com. Researchers reviewing Medicare claims found that patients who received both Medicare and Medicaid have a higher chance of being readmitted than other patients.

Hospitals that treated more of these dual-eligible patients were 24% more likely to have higher readmissions for heart attacks than hospitals that treated fewer patients from this demographic.

Because CMS doesn’t adjust its readmissions data for socioeconomic status, this means these hospitals will be penalized for having high readmissions rates.

Most hospitals struggling

The study comes on the heels of another analysis reported in Kaiser Health News stating that hundreds of the nation’s hospitals have high rates of readmissions, regardless of their patient mix.

In fact, 20% of hospitals in six states have more patients readmitted within 30 days than the national average: Maryland, New York, New Jersey, Rhode Island, Illinois and Massachusetts.

Several states are doing well overall, however, with 13% to 16% of their hospitals coming in below the national average for readmissions rates. The top performers? Oregon, Colorado, Hawaii, Idaho, North Carolina, South Carolina, Washington and Utah.

While the data in this analysis isn’t broken down by economic status of patients, the article still points out the flaws in using such data to penalize hospitals: Some hospitals may take more aggressive tactics to save patients’ lives, including readmitting them before 30 days have passed. Others may be treating patients who don’t have the financial resources to pursue follow-up care, which may land them back in the hospital.

A potential solution

The researchers who analyzed the rates of admission for dual-eligible patients proposed some potential solutions that would help hospitals struggling with high readmission rates due to factors beyond their control.

One interesting suggestion: Start comparing readmission rates among hospitals with higher percentages of dual-eligible patients, as opposed to comparing them with differently situated hospitals. This “apples-to-apples” comparison could be applied to all hospitals to give them more of an even playing field when CMS is evaluating readmissions data.

There’s hope this type of system could be put into place. Representatives from the U.S. Department of Health and Human Services and the National Quality Forum, which comes up with recommendations to improve national healthcare delivery, are planning to have a panel discussion about how economic disparities affect readmissions data and what should be done to account for them. We’ll keep you posted on any developments.

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