Readmissions. Definition: PACE participants re-admitted to an acute care hospital (excluding hospitalizations for diagnostic tests) in the last 30 days.
1. Total number of participants;
2. Total number of participants admitted to the hospital in the last 30 days;
3. Specific reason, including diagnosis, for participant’s admission; Frequency: Quarterly
Readmissions. A readmission is defined to mean any subsequent admission to an acute care facility that occurs within the Episode Period. However, whether a Readmission is included in the contracted episode rate (and thus may not be separately billed) depends on: a) the facility where the patient is readmitted, and b) whether the readmission is considered to have been caused by or related to the Index Procedure (according to rules below). Hospital and Physician Group agree that patients will be readmitted to Hospital except when: the patient requires emergency admission to a closer facility, the patient requires care that cannot be provided at Hospital, or the patient refuses to be readmitted to the Hospital. A readmission at the Hospital is assumed to be related to the Index Procedure and is included in the episode price (may not be separately billed) if the readmission groups to one of the defined set of DRGs below. 175, 176—Pulmonary embolism 294, 295—Deep vein thrombophlebitis 463, 464, 465—Wnd debrid & skn grft, exc hand, for musculo-conn tiss dis 466, 467, 468—Revision of hip or knee replacement 485, 486, 487, 488, 489—Knee Procedures with and without pdx of Infection 539, 540, 541—Xxxxxxxxxxxxx 000, 000—Bone diseases & arthropathies 555, 556—Signs & symptoms of musculoskeletal system & conn tissue 559, 560, 561—Aftercare, musculoskeletal system & connective tissue 564, 565, 566—Other musculoskeletal sys & connective tissues diagnoses 602, 603—Xxxxxxxxxx 000, 000, 000, 000, 000—Post-operative or post-traumatic infections 870, 871, 872—Septicemia or severe sepsis (note: these DRGs are included only if septicemia is related to a septic joint or central line infection) 901, 902, 903—Wound debridements for injuries 919, 920, 921—Complications of treatment 939, 940, 941—O.R. procedure with diagnosis of other contact w health services 175, 176—Pulmonary embolism 294, 295—Deep vein thrombophlebitis 463, 464, 465—Wnd debrid & skn grft, exc hand, for musculo-conn tiss dis 466, 467, 468—Revision of hip or knee replacement 480, 481, 482—Hip & Femur procedures except major joint 533, 534—Xxxxxxxxx xx Xxxxx 000, 000—Fractures hip and pelvis 537,538—Sprains, strains, dislocation hip , pelvis, thigh 539, 540, 541—Xxxxxxxxxxxxx 000, 000—Bone diseases & arthropathies 555, 556—Signs & symptoms of musculoskeletal system & conn tissue 559, 560, 561—Aftercare, musculoskeletal system & connective tissue 564, 565, 566—Other mu...
Readmissions. For purposes of the Bundled Payment Program, a Readmission is defined to mean any subsequent admission to an acute care facility that occurs within the Episode Period. However, whether a Readmission is included in the contracted episode rate (and thus may not be separately billed) depends on: a) the facility where the patient is readmitted, and b) whether the readmission is considered to have been caused by or related to the Index Procedure (according to rules below). • Provider agrees that Covered Persons will be readmitted to the applicable hospital (i.e., the hospital participating under the Bundled Payment Program (the “Participating Hospital”)) except when: the Covered Person requires emergency admission to a closer facility, the Covered Person requires care that cannot be provided at the Participating Hospital, or the Covered Person refuses to be readmitted to the Participating Hospital. • A readmission at to the Participating Hospital is assumed to be related to the Index Procedure and is included in the episode price (may not be separately billed) if the readmission groups to one of the defined set of DRGs below. • 175, 176—Pulmonary embolism • 294, 295—Deep vein thrombophlebitis • 463, 464, 465—Wnd debrid & skn grft, exc hand, for musculo-conn tiss dis • 466, 467, 468—Revision of hip or knee replacement • 485, 486, 487, 488, 489—Knee Procedures with and without pdx of Infection • 539, 540, 541—Osteomyelitis • 553, 554—Bone diseases & arthropathies • 555, 556—Signs & symptoms of musculoskeletal system & conn tissue • 559, 560, 561—Aftercare, musculoskeletal system & connective tissue • 564, 565, 566—Other musculoskeletal sys & connective tissues diagnoses • 602, 603—Cellulitis • 856, 857, 858, 862, 863—Post-operative or post-traumatic infections • 870, 871, 872—Septicemia or severe sepsis (note: these DRGs are included only if septicemia is related to a septic joint or central line infection) • 901, 902, 903—Wound debridements for injuries • 919, 920, 921—Complications of treatment • 939, 940, 941—O.R. procedure with diagnosis of other contact w health services • 175, 176—Pulmonary embolism • 294, 295—Deep vein thrombophlebitis • 463, 464, 465—Wnd debrid & skn grft, exc hand, for musculo-conn tiss dis • 466, 467, 468—Revision of hip or knee replacement • 480, 481, 482—Hip & Femur procedures except major joint • 533, 534—Fractures of Femur • 535, 536—Fractures hip and pelvis • 537,538—Sprains, strains, dislocation hip , pelvis, thigh • 539, 540, 541...
Readmissions. HSAG desires to access the Hospital’s data held by NHSN (“Data Stewards”) and electronic health record (EHR) data, when available and applicable, to permit its use to measure and track HQIC performance between September 18, 2020 and September 17, 2024.
Readmissions. IHI, State of Michigan (Readmission data sent to MI-lA/MPRO as part of the IHI STAAR project)
Readmissions. Mercy Hospital has begun a multi-year effort to address readmissions for heart failure. With its partners at Metropolitan Heart and Vascular Institute, the Mercy Heart Failure Clinic helps manage patients who are discharged from the hospital with heart failure, to ensure that they are able to stabilize and manage their condition once they return home, and aren’t hospitalized again within a short time frame.
Readmissions. The SME recommends that the State conduct an analysis of children with readmissions to identify the factors that precipitated or likely led to readmission.
Readmissions. Revenue lost due to readmissions at each facility during FY19 is shown in Table 6 below: If we reach our goals of 5% reduction in readmissions per year at each rural facility, we are able to calculate the cost savings below (Tables 7-10): Table 7: Grant Year 1 Expected Savings (5% readmission rate decrease) Year 1 Projected Total Readmissions Expected revenue lost per readmission Total Revenue Lost Easton 458 $1,961.00 $898,138.00 Dorchester 159 $1,470.00 $233,730.00 Chestertown 42 $2,088.00 $87,696.00 Easton 433 $1,961.00 $849,113.00 Dorchester 150 $1,470.00 $220,500.00 Chestertown 40 $2,088.00 $83,520.00 From the above cost-savings calculations, the combined revenue saved for each year of the grant is shown in Table 11. Table 11: Combined Cost Savings by Year Grant Year Averted Transfer Savings Surge Pool Savings Readmissions Savings Total for Year 1 $83,162.50 $8,551.83 $66,431.00 $158,145.33 2 166,325.00 $17,103.36 $136,911.00 $320,339.36 3 $249,487.50 $25,655.49 $203,342.00 $478,484.99 4 $332,650.00 $34,207.32 $270,264.00 $637,121.32 Based on this data, the project will reach sustainability by Year 2, and have a net benefit to UMMS and the UM Shore Regional system by year 3 and 4. Demonstrated financial success of the project with substantial net cost-savings at year 4 will demonstrate financial solvency to the University of Maryland Medical System and allow the hospital system to financially take control of the project after the award period.
