Many acute care providers are familiar with bounce-backs - chronic disease suffers who are stabilized in an inpatient setting, discharged to the community or a SNF, yet soon decompensate and “bounce back” to the acute care hospital. These patients can cycle relentlessly and traumatically between hospital and home. That’s debilitating for the person, as well as unnecessarily costly. For example, in 2013 hospitals admitted over 600,000 Medicare beneficiaries to treat congestive heart failure. The cost of each initial stay was almost $11,000, on average³. However, 23% of those patients were readmitted within 30 days of discharge, with the readmission per patient costing an average of $14,263.
Other chronic diseases, such as chronic obstructive pulmonary disease (COPD), follow a similar pattern. Overall, CMS estimates it spends $26 billion each year on readmissions – 65% of which is potentially avoidable⁴. For specific chronic conditions, Medicare is now penalizing readmissions. Hospitals with “excessive readmissions” are faced with a financial penalty at year-end. In the next financial year, over 75% of acute care hospitals faced that penalty, with the total penalties estimated at $528m⁵.