Hospital-Wide Adult All-Payer Readmissions in Massachusetts
Hospital readmissions are a central issue in efforts to improve health care quality and reduce costs, due to readmissions being a costly and potentially preventable problem that impacts patient health and experience of care both nationally and in Massachusetts.
CHIA currently releases three analytic products annually concerning readmissions:
- The report Hospital-Wide Adult All-Payer Readmissions in Massachusetts: SFY 2011-2015, released in December 2016, takes a statewide look at readmissions in Massachusetts acute care hospitals, providing insights into statewide, regional, and hospital-specific readmission rates, including data cuts by payer type, discharge setting, and hospital characteristics.
- The Hospital Readmissions Profiles series, update in April 2017, includes a short graphical report for each acute care hospital in the Commonwealth. These profiles provide more in-depth readmission statistics for each hospital broken out by several factors and presented in the context of the statewide figures.
- The report Behavioral Health and Readmissions in Massachusetts Acute Care Hospitals, released in August 2016, examines the readmission patterns for individuals with comorbid behavioral health conditions in Massachusetts acute care hospitals.
Hospital-Wide Adult All-Payer Readmissions Report (SFY 2011-2015)
(Published December 2016)
In this report, released in December 2016, CHIA found that the statewide all-payer readmission rate increased slightly from 2014 to 2015. Readmissions continued to vary greatly by several of the patient and system characteristics studied, including patient age, payer type, and discharge setting. This report's findings suggest potential opportunities to focus efforts on the subset of patients who are frequently hospitalized.
- The all-payer readmission rate for Massachusetts acute care hospitals in state fiscal year 2015 rose to 15.8%, up from 15.3% in 2014. The five-year trend reflects declining rates from 2011 to 2013 and increasing rates from 2013 to 2015.
- A small proportion of frequently-hospitalized patients (7%) account for a large proportion of readmissions (58%).
- While rates for Medicaid patients declined across the five-year period from SFY 2011 to 2015, the rates for Medicare and commercially-insured patients declined from 2011 to 2013, but increased from 2014 to 2015.
- Few hospitals had risk-standardized rates—which account for factors that may impact readmissions, including patient case mix and hospital service mix—in 2015 that were significantly above the statewide rate.
- There is significant consistency in readmissions by hospital over time; six hospitals had risk-standardized rates consistently in the highest quartile (top 25%) across the five years studied, while five hospitals had rates consistently in the lowest quartile during this period.