More nursing homes, physicians linked to lower hospital readmissions
Medicare patients were readmitted to hospitals less frequently in communities with more nursing home beds and primary care physicians, a new Health Affairs study shows.
Why it matters: Hospitals can be penalized when patients cycle through their doors repeatedly under the federal Hospital Readmissions Reduction Program. But that program does not account for the continuum of care within each community that hospitals rely on to take their discharged patients, the study authors write.
Where Medicare patients get discharged after heart failure and pneumonia appears to affect the odds of whether or not they will return to the hospital within 30 days, according to CMS data from 2013 to 2019 the study authors analyzed.
- Understanding the discharge options hospitals in hospitals' markets could improve the CMS algorithm used in the Hospital Readmissions Reduction Program, according to the study.
- It could "lead to lower readmission targets" for hospitals that operate in regions with more nursing homes and primary care providers, as well as higher targets for hospitals with more home health agencies in their community.
Yes, but: Hospitals in communities with more home health agencies and nurse practitioners experienced higher readmission rates, the study found, although that could be attributed to more frequent staffing changes and discontinuity in home health care, the study authors noted.
- "We would not recommend risk adjustment for nurse practitioner supply on the basis of these results," the authors note.