Unplanned hospital readmissions remain a problem in Massachusetts
BOSTON >> Unplanned patient readmissions to hospitals, which drive up health care costs because they are often preventable, remain a problem in Massachusetts where 78 percent of hospitals face federal penalties for having higher-than-expected readmissions in the most recent federal fiscal year.
A Center for Health Information and Analysis report, released at noon on Tuesday, showed 81 percent of readmissions were for patients covered by public or government payers. The report also found the readmission rate for commercial payers was 10.3 percent, compared to 17.4 percent for Medicare and 17 percent for Medicaid.
The report concluded that 7 percent of patients account for 58 percent of frequent hospitalizations, which is defined as patients with four or more hospital visits per year. A readmission is defined as an unplanned admission that occurred within 30 days of a discharge from an acute care hospital.
Across all payer types, the statewide readmission rate held flat at 15.3 percent in 2014 and has hovered within one percent of that mark for the past four years, dropping only slightly from its recent high of 16.1 percent in 2011.
The report examined rates at specific hospitals - from Holyoke Medical Center at 13.7 percent to Tufts Medical Center at 17.8 percent - and regions of the state. According to the report, a federal readmissions reduction program is penalizing acute care hospitals in the U.S. $420 million in federal fiscal year 2016 for higher-than-expected readmission rates and the percentage of hospitals fined and the average level of fines in Massachusetts are both greater than in most other states.
Over a four-year period ending in 2014, hospitals consistently within the highest quartile for readmission rates were Beth Israel Deaconess Medical Center, Brigham and Women's Hospital, Hallmark Health, Northeast Hospital, Steward St. Elizabeth's Medical Center, Tufts Medical Center and UMass Memorial Medical Center, according to the report.
Hospitals consistently within the lowest quartile for readmission rates were Cape Cod Hospital, Emerson Hospital, HealthAlliance Hospital, Lawrence General Hospital, and North Shore Medical Center.
Heart failure, septicemia and disseminated infections, chronic obstructive pulmonary disease, renal failure, pneumonia and kidney and urinary tract infections were among the most commonly diagnosed readmission conditions.
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