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WCHQ launches readmissions rate
pilot project Evolving from WCHQ’s Hospital Measures Workgroup, the Readmission Rate Subcommittee was formed in November 2009 to spearhead the Readmission Rate Measures project. First up on the subcommittee’s to do list was to create the reporting specifications to collect the data and solicit WCHQ member organizations to participate by reporting their data. To date, five organizations have agreed to report their readmission data from calendar years 2008 and 2009: Froedtert & The Medical College of Wisconsin, Gundersen Lutheran Medical Center, Mercy Hospital Janesville, Ministry Saint Joseph’s Hospital, and University of Wisconsin Hospital and Clinics. The pilot project is initially looking at an all-cause readmission rate which will include all hospitalizations regardless of the diagnosis, even if the readmission hospitalization diagnosis is different from the original admission. Once the methodology and the data have been validated, it is the subcommittee’s intention to consult with the Engelberg Center for Health Care Reform to help determine the next steps. Further analyses might include stratifying the data by primary diagnoses, payer types and patient characteristics (e.g., race, age, gender). “Presently the Centers for Medicare & Medicaid Services (CMS) reports readmissions rates for only acute myocardial infarction (AMI), pneumonia and congestive heart failure (CHF). Our goal is to take the CMS methodology, modify it as necessary, and expand on it by looking at all patients and all payers,” said Mary Gordon, WCHQ’s clinical information manager and the project’s coordinator. “Ultimately we hope to be able to publicly report readmission rates on a variety of diagnosis types in addition to the three CMS reports on. These could include chronic obstructive pulmonary disease (COPD), asthma, stroke and total hip and knee replacements, among others,” added Gordon. “We are excited to participate in this pilot project for a number of reasons,” stated Andy Weier, director of quality analysis and decision support at Ministry Saint Joseph’s Hospital in Marshfield. “First and foremost, it is the right thing to do by our patients. We hope to gain a better understanding of how we compare to other institutions and look forward to sharing best practices with our fellow WCHQ members. With the focus on readmissions by policy makers, it is also entirely possible reimbursement mechanisms will take into account readmission rates. WCHQ has done a great job historically focusing on ambulatory measures and it is great to see them develop inpatient measures as well,” said Weier. Adam Wilk, project manager/programmer at the Engelberg Center for Health Care Reform, has been serving as an advisor to the subcommittee. “Measuring readmissions is more complicated than you might think,” said Wilk. “Transparency and stakeholder collaboration are two important elements of getting the metric right, though these can also lead to a lengthy process. We are encouraged by the progress WCHQ has made to this point and look forward to continuing the effort to develop a reporting system and measurement tool they can use to provide their members with actionable information.” “Ultimately it is our goal to publicly report readmission data in such a fashion that it can be useful to both our members and the public,” said Gordon. “In addition, we encourage more facilities to join the pilot project at any time. The more participation we have, the better the resulting metric will be,” she added. For more information about this project, please contact Mary Gordon at 608-775-4519 or at mgordon@wchq.org * New England Journal of Medicine, April 2, 2009 360(14):1418–28 |
According
to a study published in 2009 in the New England Journal of Medicine,
about one in five Medicare patients nationally returns unexpectedly
to the hospital within 30 days of being sent home* — a statistic
that has caught the eye of industry experts and policy makers searching
for ways to control healthcare costs and improve the quality of care.
Given the heightened interest in readmissions, WCHQ, with consultative
support from the Engelberg Center for Health Care Reform at Brookings,
has launched a pilot project to study the methodologies involved
in collecting data and reporting on this critical issue.
