Reduce Readmissions With Pharmacy Programs That Focus on Transitions From the Hospital to the Community

ISMP Medication Safety Alert 

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The stakes have never been higher for hospitals to prevent patient readmissions within 30 days. As of October 2012, penalties enacted with the Affordable Care Act will be levied against hospitals with high readmission rates for three targeted conditions—heart failure, heart attack, and pneumonia—which may expand to additional conditions including joint replacement, cardiac stenting, heart bypass, and stroke treatment by 2015. The penalties are capped at 1% of Medicare reimbursements in 2013, 2% in 2014, and 3% in 2015. The government estimates that the penalties for fiscal year 2013 will total $280 million,[1] which represent an average penalty of about $125,000 from 2,217 hospitals.[2] Nearly 1 in 5 older adults is readmitted to a hospital within 30 days of discharge.[3] Given that more than half of these readmissions are preventable,[3–4] the new penalties are compelling hospitals to make the reduction of readmissions a priority.

Because penalties for readmissions are based on a 3-year rolling average—fiscal year 2013 payments are based on July 2008 through June 2011 readmission data—efforts to reduce the readmission rate started today will not be fully realized for several years. Thus, the goal of many hospitals will be to get off the penalty list as soon as possible.