Hospital Readmissions Fact Sheet



Hospital Readmissions Fact Sheet

• Readmission is defined by the Centers for Medicare and Medicaid Services (CMS) as an admission to a hospital within 30 days of discharge from the same or another hospital.

• Almost one in four hospital patients who are transferred to nursing homes are readmitted to the hospital within 30 days – and many of these are avoidable.

• Avoidable readmissions cost Medicare almost $18 billion in excess spending, according to CMS.

• Hospitals face reimbursement penalties for readmissions under the new Affordable Care Act (health care reform law), which took effect Oct. 1, 2012. These penalties account for 3% of a hospital’s Medicare reimbursements.

• Protecting Access to Medicare Act requires public reporting of readmission rates for post-acute providers as of October 1, 2017. This data will be available on CMS’ website, Nursing Home Compare.

• Medicare reimbursement rates for post-acute providers will be based partially on readmission performance scores as of October 1, 2018.

• INTERACT (Interventions to Reduce Acute Care Transfers) is a quality improvement program that focuses on the management of acute change in resident condition. It includes clinical and educational tools and strategies for use in every day practice in long-term care facilities.

• The INTERACT quality improvement program was developed by an interdisciplinary team led by Dr. Joseph Ouslander at Florida Atlantic University, whose primary area of research interest is long-term care quality.

• INTERACT is a quality improvement program designed to improve the early identification, assessment, documentation, and communication about changes in the status of residents in

skilled nursing facilities. The goal of INTERACT is to improve care and reduce the frequency of potentially avoidable transfers to the acute hospital.

• Medline Industries, Inc., the country’s leading provider of medical supplies and services to the long-term care industry, has an exclusive partnership with FAU to make available online training on the INTERACT quality improvement program through Medline’s online clinical resource Medline University (MU). The online materials help to train providers on how to effectively use the INTERACT quality improvement program.

• There are many programs available in the marketplace designed to reduce readmissions, but INTERACT has proven effectiveness and is recommended by the Centers for Medicare and Medicaid Services.

• An initial study of 25 nursing homes using the INTERACT quality improvement program showed those facilities achieved a 17 percent reduction in hospital admissions among residents. Projected savings to Medicare of reduced hospitalizations from a 100-bed nursing home were $125,000 per year at a cost of only $7,700 to implement the INTERACT program1.

1. Ouslander JG, Lamb G, Tappen R, Herndon L, Diaz S, Roos BA, Grabowski DC, Bonner A. Interventions to Reduce Hospitalizations from Nursing Homes: Evaluation of the INTERACT II Collaborative Quality Improvement Project. JAGS. 2011; 59:745-753.

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