Hospital-Wide Adult All-Payer Readmissions and Revisits in Massachusetts
Accounting for Social Risk Factors
Statewide Workgroup Report
Massachusetts Hospital-Wide Adult All-Payer Readmissions SFY 2011-2018 Infographic
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Accounting for Social Risk Factors in Public Reporting on Unplanned Hospital Readmissions in Massachusetts:
A Workgroup Report (Released February 2020)
CHIA has released a report from the statewide Social Risk Factors and Readmissions Workgroup, which details the proposed solution for accounting for social risk factors in the public reporting of all-payer, unplanned hospital readmissions.
In 2018 and 2019, CHIA convened a multi-stakeholder workgroup to consider whether CHIA should account for social risk factors in its analysis of hospital readmissions, and if so, to provide recommendations for doing so given the available data sources and methods.
CHIA has adopted a conceptual framework for social risk factors and expanded its existing risk-adjustment model to incorporate patient- and community-level social risk factors. This enhanced methodology will be used in CHIA’s December 2020 annual readmissions report.
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 most recent report Hospital-Wide Adult All-Payer Readmissions in Massachusetts: SFY 2011-2018, released in December 2019, 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, released in March 2019, offers a 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.
- NEW! In October 2020, CHIA released its next report on Behavioral Health and Readmissions in Massachusetts Acute Care Hospitals. This report is a statewide, all-payer examination of the prevalence of behavioral health comorbidities and readmissions among hospitalized adults in Massachusetts acute care hospitals. Given the high hospital utilization and cost associated with comorbid behavioral health conditions, stakeholders share a growing awareness that patients with behavioral health comorbidities may have a higher than average risk of readmissions, thus any efforts to reduce readmissions should include identifying risk factors associated with these populations.
Providers, payers, and policymakers are increasingly turning their attention to whether the patient returns to the acute care setting at any level (emergency department (ED), observation, or inpatient) within 30 days of inpatient discharge.