According to a report from researchers at Penn State, the Weill Cornell Medical College, and the University of Pennsylvania, reducing preventable readmission rates among Medicare beneficiaries may take longer than expected due to the challenges of care coordination. One-in-five Medicare beneficiaries returns to the hospital within 30 days of discharge, costing a total of $18 billion to the program, the authors of the report say.
Researchers of the report examined the State Action on Avoidable Rehospitalizations (STAAR), which aims to reduce hospital readmissions in Massachusetts, Michigan, and Washington by 20 to 30 percent. From a series of interviews with STAAAR directors, advisers, participants, providers, and other stakeholders, the researchers deduced that collaborative relationships among providers in different care settings is the integral ingredient to reducing readmission rates.
However, this is easier said than done, according to Jessica Mittler, assistant professor of health policy and administration at Penn State and one of the report’s authors. These collaborations are not naturally occurring in most communities, the researchers report. Also, a challenge lies in the lack of evidence that shows the effectiveness of various interventions for reducing readmissions, especially for care outside the hospital. The researchers also said efforts were limited because of infrastructure woes.
"Even the most dedicated and forward-thinking participants made it clear that there is no quick fix," Mittler said in a statement. "We learned that efforts to reduce hospital readmissions on a large scale will need to focus explicitly on promoting real collaboration across care settings. This means that policies need to consider the economic incentives for coordinating care and how to help cultivate productive human relationships to improve quality across settings."
The results of the report were published in a recent issue of Population Health Management.