BNA’s Health Care Daily Report™ sets the standard for reliable, high-intensity coverage of breaking health care news, covering all major legal, policy, industry, and consumer developments in a...
By Michael D. Williamson
Jan. 26 — Hospitals are being asked to follow a set of recommendations aimed at preventing avoidable readmissions among racially and ethnically diverse Medicare beneficiaries that the CMS outlined in a Jan. 26 guide.
Many of the practices outlined in the Centers for Medicare & Medicaid Services guide are already being implemented by hospitals, Akin Demehin, senior associate director of policy at the American Hospital Association, an industry group, told Bloomberg BNA in a Jan. 26 e-mail.
The “Guide to Preventing Readmissions Among Racially and Ethnically Diverse Medicare Beneficiaries” also includes examples of initiatives and strategies that may be applied to reduce readmissions in diverse populations. “Racial and ethnic minority populations are more likely than their white counterparts to be readmitted within 30 days of discharge for certain chronic conditions, such as heart failure, heart attack, and pneumonia, among others,” the CMS said in a press release.
Social, cultural and linguistic barriers also contribute to higher readmission rates among diverse beneficiaries, according to the guide, which was released by the CMS Office of Minority Health (OMH).
Research has demonstrated that unplanned readmissions cost Medicare $17.4 billion in 2004, the guide said, adding that 20 percent of Medicare fee-for-service patients were readmitted within 30 days of discharge. The report said as a result of these statistics, the CMS, through congressional direction and Obama administration initiatives, implemented the Hospital Readmissions Reduction Program (HRRP) in 2012, which penalizes hospitals with relatively higher rates of Medicare readmissions.
The first step toward reducing readmissions among racially and ethnically diverse populations is to collect data that identifies who is commonly being readmitted, for what condition, from what location, due to what factors, and at what cost, according to the guide. “Developing a better understanding of these particulars is essential to having a strong grasp on what underlies the readmission rate,” the CMS said. In particular, the guide called on providers and researchers to collect demographic information about the race, ethnicity, language, education status, social determinants (factors such as social support, access to healthy foods and safe, affordable places to exercise, availability of transportation, etc.), and disability status of readmitted patients.
The AHA's Demehin told Bloomberg BNA that many hospitals have redoubled their efforts to use data to identify opportunities for improvement. “Indeed, nearly 1,000 hospitals and 35 state and metropolitan hospital associations have pledged to examine their performance on quality measures by race, ethnicity, and language, and implement plans to address any disparities in care,” Demehin said.
Once data effectively identify the “targets” or those patients, populations and characteristics that are linked to readmissions, providers can begin a process that focuses on addressing the barriers and developing systems to prevent them, the report said. “Familiarity with the target should lead to a series of preemptive efforts that span the duration of pre-admission to post-discharge. These efforts are especially important for vulnerable, minority populations where complexity may require more time for providers to effectively communicate and address patients’ needs,” the guide said.
Moreover, the CMS recommended that hospitals and other providers develop a team approach to avoiding readmissions among diverse populations. All evidence points to the risks for readmissions being myriad and involving many factors and these risks can't be addressed solely by doctors, nurses or social workers, the guide said. Success will be predicated on a multidisciplinary team—which may include pharmacists, nutritionists, mental health providers, substance abuse services and other nontraditional health professionals—that is able to effectively communicate the steps that patients can take to avoid readmissions.
The guide also suggested hospitals develop interventions to prevent readmissions, especially in vulnerable, minority populations, through:
The purpose of the guide is to better position the CMS to support “Quality Improvement Networks and Quality Improvement Organizations (QIN-QIOs); Hospital Engagement Networks (HENs); federal, state, local, and tribal organizations; providers; researchers; policymakers; beneficiaries and their families; and other stakeholders in activities to achieve health equity,” the report said. It also said priorities, activities and recommendations described in the document were identified during a year-long process that included examining the evidence base, identifying opportunities and gathering stakeholder input, according to the agency.
The OMH, in collaboration with National Opinion Research Center at the University of Chicago, produced the report as part of its broad range of work to achieve health equity.
To contact the reporter on this story: Michael D. Williamson in Washington at email@example.com
To contact the editor responsible for this story: Janey Cohen at firstname.lastname@example.org
All Bloomberg BNA treatises are available on standing order, which ensures you will always receive the most current edition of the book or supplement of the title you have ordered from Bloomberg BNA’s book division. As soon as a new supplement or edition is published (usually annually) for a title you’ve previously purchased and requested to be placed on standing order, we’ll ship it to you to review for 30 days without any obligation. During this period, you can either (a) honor the invoice and receive a 5% discount (in addition to any other discounts you may qualify for) off the then-current price of the update, plus shipping and handling or (b) return the book(s), in which case, your invoice will be cancelled upon receipt of the book(s). Call us for a prepaid UPS label for your return. It’s as simple and easy as that. Most importantly, standing orders mean you will never have to worry about the timeliness of the information you’re relying on. And, you may discontinue standing orders at any time by contacting us at 1.800.960.1220 or by sending an email to email@example.com.
Put me on standing order at a 5% discount off list price of all future updates, in addition to any other discounts I may quality for. (Returnable within 30 days.)
Notify me when updates are available (No standing order will be created).
This Bloomberg BNA report is available on standing order, which ensures you will all receive the latest edition. This report is updated annually and we will send you the latest edition once it has been published. By signing up for standing order you will never have to worry about the timeliness of the information you need. And, you may discontinue standing orders at any time by contacting us at 1.800.372.1033, option 5, or by sending us an email to firstname.lastname@example.org.
Put me on standing order
Notify me when new releases are available (no standing order will be created)