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Harrisburg, PA - April 26, 2012 - Approximately two of every 15 adult hospital stays in Pennsylvania in 2010, or 13.5 percent, were followed by at least one readmission for any reason within 30 days, according to a report issued today by the Pennsylvania Health Care Cost Containment Council (PHC4). A readmission that was specifically due to a complication or infection followed 5.6 percent of all adult hospital stays.
Readmissions in Pennsylvania cost the federal Medicare program close to a half billion dollars in the most recent year for which data was available. In 2009, Medicare fee-for-service paid a total of $498 million for repeat stays that occurred within 30 days alone (not including the original hospital stay) in the state, covering 36.8 percent of all readmissions. In Pennsylvania, Medicaid fee-for-service paid for 3 percent of all readmissions that occurred within 30 days, a total of $29 million in payments.
PHC4 in recent years has included some readmission statistics in many of its publications on various health care topics, but this is the first time the agency has released a report devoted specifically to patients’ hospital returns. Although the federal government has examined readmissions for Medicare recipients, such comprehensive studies as this one -- all adult (age 18 and older) readmissions for all conditions for all general acute hospitals covering a population base as large as Pennsylvania’s-- are rare.
Joe Martin, executive director of PHC4, noted that not all readmissions are preventable. They can result from a variety of factors, including the follow-up care that a patient receives, a patient’s willingness or ability to follow post-discharge instructions, and even things such as a patient’s diet, access to transportation, insurance coverage and more. Sometimes they are pre-planned.
“Preventable readmissions are receiving more attention because they present important opportunities to improve patient care and reduce costs,” Martin said. “The medical community and government policymakers still have a great deal of work ahead in understanding the causes behind repeat hospital visits. The availability of good data is a key part of any effort to reduce readmissions.”
Readmissions are coming under increasing scrutiny nationally as both a potential quality-of-care indicator and as a significant cost factor. The Medicare Payment Advisory Commission has estimated that potentially preventable readmissions might account for as much as $12 billion per year in medical costs nationally. Later this year, Medicare will begin to impose financial penalties on hospitals that have an excess of preventable readmissions for some conditions.
Among the other key findings in the PHC4 2010 report:
PHC4 is an independent state agency charged with collecting, analyzing and reporting information that can be used to improve the quality and restrain the cost of health care in Pennsylvania. Copies of the free report can be downloaded from PHC4’s website at http://www.phc4.org.
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