Medicare Rehospitalization Costs $17 Billion a Year
As many as 20% of all Medicare patients released from a hospital will be readmitted again within 30 days. These unplanned readmissions are often the result of missed or inadequate follow-up care recommended upon release from the first hospitalization. Rehospitalization, as these unplanned readmissions are called, is likely to last longer, involve life-threatening medical conditions, and they cost taxpayers about $17 billion each year.
Thursday’s issue of the ‘New England Journal of Medicine’ includes the study of unplanned readmissions by Medicare recipients for 2003 and 2004. It suggests confirmation of President Barack Obama’s statements that improving follow-up care can reduce the rate of rehospitalization and save billions of dollars. The budget he proposed in February includes an anticipated $26 billion savings over 10 years by simply reducing the number of hospital readmissions.
Most patients, including Medicare patients, leave a hospital confinement with instructions for follow-up care. The study indicates as many as 20% of Medicare patients, about 2.3 million people, don’t get that recommended follow-up care but face life-threatening medical crises shortly after release that might have been prevented or minimized if doctors’ recommendations had been followed. Many of the high-risk medical conditions that lead to rehospitalization include gastrointestinal distress, heart failure, and pneumonia.
The study also suggests hospitals should take a more active role in making sure patients get the recommended follow-up care after hospitalization while acknowledging that this may prove to be a difficult mission. The study says hospital economics are a factor since repeat patients are repeat business and that longer, second hospitalizations don’t necessarily mean more income to the hospital. It’s true rehospitalization often requires a longer stay involving greater utilization of hospital resources but hospitals are reimbursed at about the same per-patient rate as when hospital stays are shorter.
My grandmother’s two readmissions were due to both the hospital and her physician’s error and negligence. First, her discharge instructions were vague and confusing at best, and second, a potential infection was missed by both the nursing staff and her physician. I think that Medicare should refuse reimbursement to these entities for these errors. Our family is going to fight this. My message is for the family to be diligent.
The new 2011 medicare preventative services have it wrong, they need to give incentive to things like CHF care, DM care, HTN care, not colonoscopy and PEs.