On January 26, 2016, the CMS Office of Minority Health released a new Guide to Preventing Readmissions among Racially and Ethnically Diverse Medicare Beneficiaries (Guide). The purpose of the Guide is to assist hospital leaders and stakeholders in focusing on quality, safety, and care redesign in identifying root causes and solutions for preventing avoidable readmissions among racially and ethnically diverse Medicare beneficiaries.
The Guide provides:
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guidance for addressing avoidable readmissions among racially and ethnically diverse patient populations by providing an overview of the issues related to readmission for diverse Medicare beneficiaries;
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seven key recommendations for hospital leaders to prevent avoidable readmissions among racially and ethnically diverse Medicare beneficiaries; and
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concrete examples of initiatives and strategies that may be applied to reduce admissions in diverse populations.
In outlining the seven key recommendations, the Guide states that the first step toward reducing readmissions among racially and ethnically diverse populations is to collect data “that identifies who is commonly being readmitted, for what condition, from what location, due to what factors, and at what cost.” Other recommendations for preventing avoidable readmissions among this patient population include:
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identifying the root causes and characteristics that are linked to readmissions and a process to address them;
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implementing preemptive efforts that span the duration of the pre-admission to post-discharge timeline;
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using a multidisciplinary team, which can communicate quickly, effectively, and respectfully, to address the risks for readmission;
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focusing on both creating systems responsive to the needs of diverse populations and addressing the social determinants that put them at continued and repetitive risk for readmission by, for example, providing patients with easy-to-read information that is culturally and linguistically appropriate, and linking patients to community resources;
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deploying resources that focus on patient communication and help ensure that patients understand their diagnosis, the care they receive, and their discharge instructions, among other pieces of critical information; and
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fostering community partnerships to promote continuity of care as the patient transitions back into the community.
The Guide emphasizes that as Medicare and other payors move toward value-based care, the cost and quality implications of higher readmission rates among racially and ethnically diverse patients has become a significant concern for hospitals and hospital leaders, prompting a need for additional guidance on how hospitals can prevent readmissions among these populations. The Guide cites research demonstrating that unplanned readmissions cost Medicare $17.4 billion in 2004.
The Guide is available here.
Reporter, Kristin Roshelli, Houston, +1 713 751 3263, kroshelli@kslaw.com.
