The ACO Achilles Heel: Avoidable Hospital Readmissions
Hospital readmissions are costly in every way. A patient readmitted to the hospital is twice as likely to die over the following two years. Financially, hospital readmissions represent the single largest opportunity for Accountable Care Organizations to reduce both acute and post-acute care spend. But to lower these costs, ACOs must choose those post-acute providers that will deliver optimal outcomes for their patients. Unfortunately, existing post-acute ratings systems, including the gold standard metrics created by the Center for Medicare and Medicaid Services, are retrospective, based on historical claims and self-reported data rather than real-time information. More importantly, they do not correlate with an organization’s ability to deliver optimal outcomes…