As we await the start of the new Home Health Compare (HHC) reporting of 30-day rehospitalization rates this summer, I was curious to see how rates have been changing over the last several years. With CHF widely being touted by CMS as one of the diagnosis categories with high avoidable readmissions, I figured I would start there. Using our extensive SHP National database and knowing we just finished the first three years where hospitals have been penalized for Heart Failure (HF) readmits, you can imagine my surprise.
|CHF 30 Day Rates||20.0%||19.6%||19.3%||19.5%|
Although 30 day readmits have come down over the first couple of years, it was interesting to see that rates actually ticked up in 2014. At first I didn’t think that could be right, but across our database, the 30 day rates for all diagnoses also increased slightly in 2014.
I wonder what may be the cause. Are patients coming out too quickly from hospitals? Is there enough of a penalty to hospitals to drive this rate down further? I wonder if this is a predication that Agencies will soon be subject to some kind of 30 day penalty in the near future too. Think Value Base Purchasing…
|All DX 30 Day Rates||13.1%||12.9%||12.6%||12.7%|
To go a little deeper, I looked at the 2014 CHF rates to see how they changed when different responses to the SOC M1032 Risk of Rehospitalization were checked off. When Multiple Hospitalizations in the Past 12 months were checked, the rate increased to 22.4%, History of Falls - to 21.1%, and Recent Decline in Mental, Emotional of Behavioral Status - to 21.6%. In fact, using SHP’s “High Risk of Hospitalization” algorithm, the rate goes up to 28.7%.
Agencies need to decide what level of resources they will need to commit in order to keep these patients out of the hospital. Using drill down capabilities and data analytics will surely help to identify which patients may need more of the Agency’s attention. I will plan to continue writing a series of blogs over the next couple of weeks to look more closely at 30 Day Readmits. Stay tuned!