Health law’s rules help hospitals cut patient readmission rate

Over the past several months, America’s hospitals have achieved a feat that long seemed beyond reach: substantially reducing the share of patients who must return for treatment almost as soon as they are discharged.

According to statistics compiled by the Obama administration, the nationwide rate of hospital readmissions of Medicare patients within 30 days of discharge declined to about 17.8 percent by last November after remaining stuck near 19 percent over the five years that the data has been collected, and likely for decades prior to that.

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A look at the cost of medical procedures in the U.S. compared with the rest of the world.
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A look at the cost of medical procedures in the U.S. compared with the rest of the world.

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Jonathan Blum, a top official at the Centers for Medicare and Medicaid Services, is scheduled to release the figures Thursday at a Senate Finance Committee hearing. In an interview, he argued that the drop — which has already kept tens of thousands of people out of the hospital — is largely the result of provisions in President Obama’s health-care law.

These provisions include new financial penalties that Medicare, the federal health program for the elderly and disabled, has begun imposing on hospitals with high readmission rates. They also include extra funding and incentives for hospitals and outpatient providers to do a better job of coordinating care for patients after they head home.

“What I think is exciting is that a couple years ago the general reaction to these policies was that it was impossible to reduce hospital readmissions,” Blum said. “And what this data shows me is that it is possible. . . . I believe that what we are seeing is a fundamental, structural change.”

The news comes as the growth of health-care spending is slowing at a record pace.

For a variety of reasons, national spending on health care in 2011 grew by less than 4 percent for the third consecutive year. And in 2012, Medicare’s spending per beneficiary rose by only 0.4 percent, compared to an average of 1.9 percent in the preceding three years.

Yet many analysts say that Medicare continues to threaten the country’s long-term fiscal health, primarily because of the aging of the baby boomers. Administration officials hope that reducing unnecessary hospital readmissions will be a powerful, and politically palatable, tool for further curbing Medicare spending.

The data does not pinpoint the reasons for the reduction in the Medicare readmissions rate. But officials stressed that the decline occurred as hospitals began focusing more on readmissions, in part because of a combination of carrots and sticks in the health-care law.

The law, for example, includes a stream of funding for organizations promoting better coordination of patient care, such as 26 “hospital engagement networks” across the country that are working with 3,700 hospitals to identify ways to reduce unnecessary readmissions.

One of the largest such groups, Premier Healthcare Alliance, which has a $24 million two-year contract to serve 450 hospitals, has used the money to hire an army of advisers to come up with specific strategies tailored to each location. So far, the effort has reduced the average readmissions rate from 11.2 percent in 2010 to 10.2 percent by this past September.

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