Part B Insider (Multispecialty) Coding Alert

Currently, Medicare spends approximately $17 billion annually in avoidable hospital readmissions that occur within 30 days of the original visit. With such a hefty price tag, CMS has been determined to turn around those dismal and costly statistics.

Through ACA legislation, the Hospital Readmissions Reduction Program was created with the dual goals of cutting down on this phenomenon while also improving patient care. CMS also joined with the Partnership for Patients, ensuring that going forward every effort would be made to improve both the coordination and transition of care.

The program reported data this week in a CMS blog post on Sept. 13, 2016 that reaffirmed its efforts with research showing “readmissions rates fell by 8 percent nationally” from 2010 to 2015 in all 50 states and the District of Columbia.

“Across states, Medicare beneficiaries avoided approximately 100,000 readmissions in 2015 alone, compared to if readmission rates had stayed constant at 2010 levels,” said Patrick Conway MD, CMS principal deputy administrator and chief medical officer and Tim Gronniger, CMS deputy chief of staff in the blog post. “That means Medicare beneficiaries collectively avoided nearly 100,000 unnecessary return trips to the hospital. Cumulatively since 2010, the HHS Assistant Secretary for Planning and Evaluation estimates that Medicare beneficiaries have avoided 565,000 readmissions.”

For a closer look at the readmissions stats and CMS program, visit https://blog.cms.gov/2016/09/13/new-data-49-states-plus-dc-reduce-avoidable-hospital-readmissions/.

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