Study: Quality Improvement Interventions Reduce Hospital Readmissions, but Savings Vary | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

Study: Quality Improvement Interventions Reduce Hospital Readmissions, but Savings Vary

May 31, 2017
by Rajiv Leventhal
| Reprints

Although efforts to reduce hospital readmissions are working in some ways, they’re not always saving money, according to a new study from Los Angeles-based Cedars-Sinai.

Many medical centers are tackling healthcare’s readmission problem by trying to pinpoint the root causes of unnecessary repeat hospitalizations. As such, a Cedars-Sinai-led team of investigators systematically evaluated the effectiveness and financial benefit of quality improvement programs at medical centers in the U.S. and elsewhere. The study was published this week in the Journal of the American Medical Association Internal Medicine.

The team, led by Teryl Nuckols, M.D., conducted a systematic review of data from 50 quality improvement studies involving more than 16,700 patients. One of the core findings of the research was that quality improvement interventions reduced readmissions by an average of 12.1 percent for heart failure patients and 6.3 percent for older adults with diverse health issues.

However, the research also revealed that savings to health systems varied. The investigators examined how much money these interventions saved or cost health systems by measuring expenses for hospitals, physicians, other providers and payers. They found average net savings for health systems of $972 per person among heart failure patients and average net losses of $169 per person among other patients. However, costs varied so widely across studies that the authors could not conclude definitively whether these interventions saved or lost money.

The federal government’s penalties on hospitals for failing to lower their rehospitalization rates hit a new high in 2016 as Medicare withheld approximately $528 million—about $108 million more than the year prior—according to a Kaiser Health News report from last August. What’s more, the government will penalize more than half of the nation’s hospitals — a total of 2,597 — having more patients than expected return within a month.

The Hospital Readmissions Reduction Program, created by the Affordable Care Act (ACA), was designed to make hospitals pay closer attention to what happens to their patients after they get discharged. The  fines for failure to meet the criteria of the Centers for Medicare & Medicaid Services (CMS) focus on six conditions: heart attack, congestive heart failure, pneumonia, chronic obstructive pulmonary disease (COPD), elective hip and knee replacements, and for the first time last year—coronary artery bypass graft surgery.

Among older adults in the study, interventions that engaged patients and caregivers yielded the most net savings per patient, the researchers found. For example, several interventions involved nurses or pharmacists training patients and family members about how to manage medications after discharge, which types of activities are appropriate and which symptoms might represent something serious.

Nuckols, director of the Division of General Internal Medicine in the Cedars-Sinai Department of Medicine, said she was surprised that the interventions didn’t save more money across the board. Nuckols said the results counter a widely held belief that reducing readmissions should save money by preventing additional costs for return hospital stays.

“Hospitalization is very expensive, so avoiding even a few readmissions should have saved a lot of money,” she said. “Our findings suggest that there is no guarantee of net cost savings once the implementation costs associated with efforts to prevent readmissions are considered.”

Get the latest information on Health IT and attend other valuable sessions at this two-day Summit providing healthcare leaders with educational content, insightful debate and dialogue on the future of healthcare and technology.

Learn More

Topics

News

Dignity Health, UCSF Health Partner to Improve the Digital Patient Experience

Dignity Health and UCSF Health are collaborating to develop a digital engagement platform that officials believe will provide information and access to patients when and where they need it as they navigate primary and preventive care, as well as more acute or specialty care.

Report: Digital Health VC Funding Surges to Record $4.9 Billion in 2018

Global venture capital funding for digital health companies in the first half of 2018 was 22 percent higher year-over-year (YoY) with a record $4.9 billion raised in 383 deals compared to the $4 billion in 359 deals in the same time period last year, according to Mercom Capital Group’s latest report.

ONC Roundup: Senior Leadership Changes Spark Questions

The Office of the National Coordinator for Health IT (ONC) has continued to experience changes within its upper leadership, leading some folks to again ponder what the health IT agency’s role will be moving forward.

Media Report: Walmart Hires Former Humana Executive to Run Health Unit

Reigniting speculation that Walmart and insurer Humana are exploring ways to forge a closer partnership, Walmart Inc. has hired a Humana veteran to run its health care business, according to a report from Bloomberg.

Value-Based Care Shift Has Halted, Study Finds

A new study of 451 physicians and health plan executives suggests that progress toward value-based care has stalled. In fact, it may have even taken a step backward over the past year, the research revealed.

Study: EHRs Tied with Lower Hospital Mortality, But Only After Systems Have Matured

Over the past decade, there has been significant national investment in electronic health record (EHR) systems at U.S. hospitals, which was expected to result in improved quality and efficiency of care. However, evidence linking EHR adoption to better care is mixed, according to medical researchers.