Lowering readmissions: A complex challenge

By Laura Mize

Reducing hospital readmissions is a worthy goal, but that doesn’t mean it’s straightforward.

Many factors can affect whether a discharged patient returns to the hospital, including his or her compliance with health care providers’ instructions and his or her level of health literacy — both variables outside hospital control.

The challenges a hospital faces in complying with the Affordable Care Act’s readmissions standards also depend in part on its patient population. At a hospital that serves mostly Medicare patients, the federal requirements apply to a larger percentage of patients than at hospitals where most of the patients are privately insured, for example. And the more Medicare patients a hospital has, the more reimbursement money it stands to lose for noncompliance. Meanwhile, decreased reimbursements may mean budget cuts at some hospitals, making quality improvement efforts to help reduce readmissions more difficult to fund.

Lowering readmissions rates among all patients is in keeping with UF Health’s continuing quality improvement efforts.

“One of our key quality goals, or ‘big aims,’ is to decrease our 30-day all-cause readmission rate,” said Randy Harmatz, UF Health senior vice president, chief quality officer and director of the UF Health Sebastian Ferrero Office of Clinical Quality and Patient Safety. “This is a critical component of our plan to be recognized as one of the nation’s top performers in patient safety and quality.”