How is the 30 day readmission rate calculated?

The Observed Readmission Rate is the percentage of acute inpatient stays during the measurement year that were followed by an unplanned acute readmission for any diagnosis within 30 days. It is equal to the Count of 30-Day Readmissions (Column 2) divided by the Count of Index Hospital Stays (Column 1).

How is readmission rate calculated?

Readmission rate: number of readmissions (numerator) divided by number of discharges (denominator); each readmission should be counted only once to avoid skewing the rate with multiple counts.

What is the Hrrp program?

The Hospital Readmissions Reduction Program (HRRP) is a Medicare value-based purchasing program that encourages hospitals to improve communication and care coordination to better engage patients and caregivers in discharge plans and, in turn, reduce avoidable readmissions.

What is the readmission rate?

​ Definition. Percentage of admitted patients who return to the hospital within seven days of discharge. Goal. The percentage of admitted patients who return to the hospital within seven days of discharge will stay the same or decrease as changes are made to improve patient flow through the system.

What is a 30-day readmission?

The HRRP 30-day risk standardized unplanned readmission measures include: Unplanned readmissions that happen within 30 days of discharge from the index (i.e., initial) admission. Patients who are readmitted to the same hospital, or another applicable acute care hospital for any reason.

Do hospitals pay for readmissions within 30 days?

Medicare counts the readmission of patients who returned to a hospital within 30 days even if that hospital is not the one that originally treated them. In those cases, the penalty is applied to the first hospital. This year’s penalties are based on discharges from July 1, 2015, to June 30, 2018.

What is DRG readmission?

A readmission occurs when a patient is discharged/transferred from a hospital, and is readmitted to the same hospital within a day (or days) for symptoms related to, or for evaluation and management of, the prior stay’s medical condition. DRG readmissions can include more than two claims.

How much do readmissions cost hospitals?

In 2018, there were a total of 3.8 million adult hospital readmissions within 30 days, with an average readmission rate of 14 percent and an average readmission cost of $15,200.

How much does a readmission cost?

This ratio is then multiplied by the national unadjusted readmission rate for the condition for all hospitals to compute an RSRR for the hospital. So, the higher a hospital’s predicted 30-day readmission rate, relative to expected readmission for the hospital’s particular case mix of patients, the higher its adjusted readmission rate will be.

What makes a readmission under the hospital readmissions reduction program?

What counts as a readmission under the Hospital Readmissions Reduction Program? The HRRP 30-day risk standardized unplanned readmission measures include: Unplanned readmissions that happen within 30 days of discharge from the index (i.e., initial) admission.

When does a hospital readmission for SNF occur?

SNF claim Readmission to an acute care hospital Readmission is counted as long as it occurs within 30 days of discharge from the prior proximal hospital. The readmission may end the SNF stay or it may occur after the patient is discharged from the SNF. ≤ 1 day from prior proximal hospital discharge to index SNF admission