Question

• Why does the Centers for Medicare & Medicaid Services (CMS) believe that prevention of inpatient admissions will improve the quality of care in populations served by hospitals?
• What specific age group and diagnoses does the CMS monitor for readmissions?
• Does research tell us that so far prevention of readmissions has improved the quality of care for patients?
• How has hospital reimbursement been affected by the readmission standard mandated by the CMS?
• What recommendations (best practices) to decrease hospital readmissions have been suggested by experts in the healthcare field?

Answer 1

Centres for medicare and medicaid services a federal agency renders health coverage for the people in united states. Medicare is a federal program that covers health coverage for people in age group of 65 + and the people with disability. Medicaid is given by state that covers people under low social income irrespective of age. Hospital readmission refers to an episode in which the patient got discharged with in a short duration. CMS renders hospital readmissions program Hospital readmissions reduction programs focuses in reduction of payments due to excess readmissions.

CMS readmission program the following condition : CABG surgery, Heart failure, Pneumonia, Total knee arthroplasty, Heart failure, Chronic obstructive pulmonary disease. Readmission is inevitable in health sector but it needs a scientific support and a valid reason for the readmission. Medicare penalized hospitals involved in highest rate of hospital readmissions. This helps to avoid health care cost.