All Cause Readmissions
More than any other single measure, readmissions has come to define success in value-based care.
Many care factors influence patient readmissions, including diagnostic accuracy, workflow and care coordination, effective discharge planning, clinical decisions and interventions, medication management, and more. With all of those components of care quality in play, patient readmissions performance has become a bellwether for success in value-based care in hospitals.
From the inception of the ACA, the Centers for Medicare and Medicaid Services (CMS) identified preventable 30-day readmissions as a critical care quality measure—with significant reimbursement rewards and penalties for performance.
Ten years in, new discussion and debate still emerges as to whether hospitals have or have not truly decreased readmissions. The target also keeps moving, as hospitals prepare for new rules to grade readmissions performance against peer benchmarks.
The imperative for hospitals and systems remains to continue addressing readmissions performance as a top quality and financial priority. Let’s look at the data that spell out the challenges—and how the AI-based Cognitive Clinical Machine is delivering reliable success in reducing hospital readmissions rates.
The readmissions directives cover these six clinical conditions:
Heart attack Heart failure Pneumonia
Chronic obstructive pulmonary disease (COPD) Elective hip or knee replacement Coronary artery bypass graft (CABG)
Many clinical and demographic factors influence readmissions—too many for even the best clinicians to observe and consider without AI-based cognitive power:
Use of high-risk medications Multiple medications for the same condition More than six chronic conditions Unplanned hospitalizations within the last six to 12 months
Low health literacy Limited social interaction Lower socioeconomic status Discharge against medical advice
The industry data reflects the challenges in reducing and managing readmissions:
Nearly 20 percent of Medicare patients discharged from a hospital are readmitted within 30 days, which costs Medicare $15 billion to $18 billion per year
Overall, 36.1 percent of all 30-day readmissions occurred within seven days
Often inadequate discharge planning contributes to readmissions, with poor coordination among hospital and community clinicians and lack of community-based care
Medicare patients contributed to $20.1 billion in total hospital costs for potentially preventable hospitalizations
In 2017 2,573 hospitals were penalized for too many 30-day readmissions
Readmissions stays are about 50 percent longer than overall average length of acute care stay at 6.4 days (estimated mean LOS)
Patient and Healthcare Impact
Jvion has a demonstrated track record across multiple hospitals of reducing readmissions by at least 10 percent.
Consider a hospital with a readmission rate of 13 percent (1,300 readmissions per 10,000 discharges). The Jvion Cognitive Clinical Success Machine would help avoid 130 readmissions—an estimated cost savings of $1.43 million.
Grady Health System Is Working to Lower Readmissions with Jvion’s Clinical Predictions Sep 2016 | Latest Press | MoreSoutheast Alabama Medical Center Chooses Jvion to Improve Care Delivery while Reducing Patient Suffering Nov 2016 | Announcements | More
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