Is there a standard for calculating re-hospitalization rates?

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Is there a standard for calculating re-hospitalization rates?

With penalties looming October 1 this year for the nation's worst-performing hospitals, the healthcare industry is abuzz with prevention of readmissions. Executives across the country are scrambling in spreadsheets, and many are asking what underlying math to use for calculating a credible readmission rate. From the top of this article we'll start with the bottom line: there is no industry standard. Will the real math please stand up?

Don't expect to see that happen anytime soon. There are several ways to calculate re-hospitalization rates, according to AHCA:

  • AHCA 30-day SNF re-hospitalizations

  • MedPac 100d Potentially Avoidable Hospitalizations

  • CMS Value-Based Purchasing Demo 30d SNF re-hospitalization

  • CMS QIS re-hospitalization measure

Today American HealthTech is using the same formula as the AHCA 30-day SNF rate for re-hospitalization calculation:

C  Users jclement Pictures readmit calculation

Note that while the formula is the same, AHCA uses claims data and AHT uses MDS data as variables. We've been advised that AHCA is moving toward an MDS-based formula. Today, AHT clients use Outcomes Reporting to achieve fully automated re-hospitalization rate calculations using the math above. The foundation for great reporting is a robust electronic medical record system you trust.

Using AHCA’s Trend Tracker, you can get reports to benchmark your performance compared to groupings of SNFs in your region and nationwide for re-hospitalizations, survey history, star-ratings, costs, readmissions, resident characteristics, staffing, and more. Trend Tracker is free to AHCA members. AHT customers can automatically load RUG data to Trend Tracker with a push of a button.

How is your readmission strategy shaping up? Get a free white paper to measure your performance and help get hospital frequent flyers under control using simple, innovative techniques.


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