Plan All-Cause Readmissions
This HEDIS Measure
Assesses the rate of adult acute inpatient stays that were followed by an unplanned acute readmission for any diagnosis within 30 days after discharge. As well as reporting observed rates, NCQA also specifies that plans report a predicted probability of readmission in order to account for the prior and current health of the member, among other factors.
A “readmission” occurs when a patient is discharged from the hospital and then admitted back into the hospital within a short period of time. A high rate of patient readmissions may indicate inadequate quality of care in the hospital and/or a lack of appropriate post-discharge planning and care coordination. Unplanned readmissions are associated with increased mortality and higher health care costs. Unplanned readmissions can be prevented by standardizing and improving coordination of care after discharge and increasing support for patient self-management.1
1. Boutwell, A., F. Griffin, S. Hwu, D. Shannon. 2009. “Effective Interventions to Reduce Rehospitalizations: A Compendium of 15 Promising Interventions.” Cambridge, MA. Institute for Healthcare Improvement.