The Federal Agency for Healthcare Research and Quality (“AHRQ”) has released a guide to decrease hospital readmissions while providing better care to adults in Medicaid. The Hospital Guide to Reducing Medicaid Readmissions has been released after a two-year study was performed, using an evidence-based approach to provide recommendations for hospitals to reduce readmissions.

The report quickly highlights the frequency of readmissions, as the data-analysis shows “the adult, non-obstetric Medicaid population has readmission rates as high as – or even higher than – the Medicare fee-for-service population.” Readmission rates are an important issue in relation to the general quality of health care, as well as controlling health care costs.

The guide proposes six action items to expand hospital efforts in reducing readmissions for Medicaid patients:

(1)     Know your data;

(2)     Inventory readmission reduction efforts;

(3)     Develop a portfolio of strategies;

(4)     Improve hospital-based transitional care processes for Medicaid patients;

(5)     Collaborate with cross-setting partners; and

(6)     Provide enhanced services for high-risk patients.

The report provides charts allowing hospitals to customize their information and performance measures. This allows each hospital to cater best-practice recommendations to their unique administration. AHRQ recognizes that no hospital is the same, thus solutions will vary. The guide provides a thorough explanation of each action item, including a detailed purpose and description, as well as projected staff and time requirements. Further, the report takes a realistic approach in recognizing quality improvement teams often face barriers, and provides a list of common difficulties and recommendations to move past them.

AHRQ also provides a toolbox that accompanies the action steps as described above. These tools range from assisting in the collection of data on hospital patients, to providing a template to identify community resources to assemble a cross-continuum team.

These recommendations are important for every hospital to consider. As policy makers continue to focus on health care costs, reducing admissions for adult patients in the Medicaid program are necessary. While every hospital is unique, AHRQ’s guide is an appropriate way to start looking at hospital-specific solutions to a healthcare industry-wide problem.

If you have questions about the guide or other health care compliance questions, please contact one of our Kansas City Health Care Attorneys today by calling 816-421-4460.

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*This article is very general in nature and does not constitute legal advice. Readers with legal questions should consult with an attorney prior to making any legal decisions.