Reducing 30-day Readmission After Joint Replacement

Hospital readmission is a focus of quality measures used by the Center for Medicare and Medicaid (CMS) to evaluate quality of care. Policy changes provide incentives and enforce penalties to decrease 30-day hospital readmissions. CMS implemented the Readmission Penalty Program. Readmission rates are being used to determine reimbursement rates for physicians. The need for readmission is deemed an indication for inadequate quality of care subjected to financial penalties. This reviews identifies risk factors that have been significantly associated with higher readmission rates, addresses approaches to minimize 30-day readmission, and discusses the potential future direction within this area as regulations evolve.

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These system-based procedures can help to decrease readmission, and ultimately improve quality of care while decreasing health care–associated costs.

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These system-based procedures can help to decrease readmission, and ultimately improve quality of care while decreasing health care–associated costs.

In addition to the aforementioned factors, it should also be noted that as many as 50% of THA readmissions are not related to the index surgery. This suggests that they may have been planned readmissions or were unpreventable. Understanding this dynamic allows administrators to address the modifiable factors that predict readmission, while also realizing that completely eliminating readmissions may not be feasible. This should also empower physicians to advocate for appropriate reimbursement models that provide adequate compensation for the care provided, without penalizing providers or patients for unpredictable circumstances.

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