Data brief no. 28 chronic_conditions_rehospitalizations

Chronic Conditions and DataBrief: RehospitalizationsDid you know… In 2009, Medicare beneficiaries with 5 or more chronic conditions were more than twice as likely to be rehospitalized within 30 days as all other Medicare beneficiaries who were hospitalized? DataBrief Series March 2012 No. 28 ● ●

Chronic Conditions and Rehospitalizations Among Seniors • The rehospitalization of Medicare beneficiaries is a frequently occurring and significant problem.1 • Unplanned rehospitalizations can be dangerous and sometimes life-threatening. They are also costly; in 2004, the estimated cost of unplanned rehospitalizations was $17.4 billion.1 • In 2009, 38% of Medicare beneficiaries with 5 or more chronic conditions who were hospitalized during the year were rehospitalized within 30 days, as compared to 16% of all Medicare beneficiaries who were hospitalized during the year.2 • Similarly, rehospitalization rates at 60 and 90 days after an inpatient stay were significantly higher for beneficiaries with 5 or more chronic conditions compared to all Medicare beneficiaries who had an inpatient stay.21Jencks,Stephen, Mark Williams and Eric Coleman. “Rehospitalizations Among Patients in the Medicare Fee-For-Service Program.” New England Journal of Medicine 360 (2009): 1418-1428.2Avalere Health, LLC. Analysis of 2009 Medicare Standard Analytic Files. Excludes individuals who died in 2009. DataBrief (2012) ● No. 28 Page 2

Rehospitalization Rates Increase With Time, Especially for Medicare Beneficiaries With Multiple Chronic Conditions Rehospitalization Rates for Medicare Beneficiaries With One or More Inpatient Stays, 2009 60% 52% 50% 47% 40% 38% 30% 23% 20% 20% 16% 10% 0% All Medicare Beneficiaries¹ Medicare Beneficiaries with 5+ Chronic Conditions¹ 30-Day Rehospitalizations 60-Day Rehospitalizations 90-Day Rehospitalizations1N = 4,355,540 total Medicare beneficiaries with one or more inpatient stays, 372,800 total Medicare beneficiaries with 5+ chronic conditions and one or more inpatient stays. DataBrief (2012) ● No. 28 Page 3

About the data:This analysis used 2009 Medicare A Clear Policy Connectionclaims data to identify individualswith chronic conditions, using a list Rehospitalizations are potentially dangerous events for Medicareof 21 common chronic conditions beneficiaries and are very costly to Medicare. Though somederived from the Medicare Chronic rehospitalizations are unavoidable, others could be prevented by improvingCondition Working file. communication between patients and providers, reducing medication errors, and improving coordination between hospitals, post-acute, andIndividuals were defined as having a long-term care providers.1 This is particularly critical for individuals withrehospitalization if they had one or chronic conditions.more hospital admissions for any The Affordable Care Act (ACA) includes provisions to addresscause within 30 days, 60, or 90 days rehsopitalizations as a means to improve care quality and reduce costs.of a prior hospital admission. This One such provision will impose progressive reductions in Medicareanalysis is limited to individuals payments to hospitals with high 30-day rehospitalization rates beginning inenrolled in the fee-for service, or October 2012.1 Another ACA provision established the Community-Basedtraditional, Medicare program, and Care Transitions Program, which authorizes $500 million to test models for improving care transitions from hospitals to other settings and reducingexcludes beneficiaries who died in readmissions for high-risk Medicare beneficiaries through partnerships2009. between hospitals and community-based organizations. The program began in April 2011 and will run for five years. In November 2011, the Centers for Medicare and Medicaid Services announced the first seven sites selected for participation, representing communities in Georgia, Ohio, Maine, Arizona, New Hampshire, and Illinois.2 1Healthcare.gov. Roadmap to Better Care Transitions and Fewer Readmissions. Accessed December 8, 2011 at: http://www.healthcare.gov/compare/partnership-for-patients/safety/transitions.html. 2Centers for Medicare and Medicaid Services. Medicare Demonstrations: Details of the Community- BasedAnalytics powered by Avalere Health LLC Care Transitions Program. Accessed December 8, 2011 at: https://www.cms.gov/demoprojectsevalrpts/md/itemdetail.asp?itemid=CMS1239313. DataBrief (2012) ● No. 28 Page 4

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Data brief no. 28 chronic_conditions_rehospitalizations

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