Managing Unplanned Readmissions

Unplanned readmissions have long been considered an indicator for potential quality of care issues. Health plans, Medicare, Medicaid and other payers have long been concerned by the cost of these often avoidable readmissions as well as possible quality of care issues that led to the readmission.

Now hospitals who are in the 25 percent with the greatest number of risk-adjusted 30 day readmissions are about to face harsh penalties affecting all Medicare payments (not just for those directly related to readmissions). Some of these hospitals will be among those who can least afford a reduction in Medicare payments. Even with considerable improvement by all hospitals, 1 out of 4 will still statistically fall into the 25 percent whose Medicare payments are reduced.

Managing Unplanned Readmissions provides the guidelines your organization needs to manage patient care effectively to make unplanned readmissions unnecessary.

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Hospitals need to focus on the comprehensive care issues related to the management of patients with the targeted DRG diagnoses in the hospital and following hospital discharge in order to avoid readmissions. This requires a concerted coordinated effort by hospital administration, clinical staff, and the medical staff to succeed. Case management staff must follow the care of all patients (whether at home, in a SNF, or another location) who were admitted or discharged with the currently targeted diagnoses of pneumonia, heart failure or acute myocardial infarction.

Managing Unplanned Readmissions details the key issues and guideslines in these areas:

  • Advanced Directives
  • Health Coaches
  • Hospitalists; Medical Extensivists
  • Translation/Language Interpreters
  • Walk-in Clinics/Urgent Care Centers
  • ER care issues may increase hospital readmissions
  • Discharge issues

Unplanned readmission are largely an avoidable cost a potential, unrealized, incentive to create a management strategy that will benefit patients, health care organizations and the various organizations that pay for healthcare services. Order your copy of Managing Unplanned Readmissions today online at:


Melanie Matthews
Executive Vice President
The Healthcare Intellligence Network

P.S. You may also be interested in the following upcoming webinars on readmissions: