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SPECIAL ARTICLE HEALTH CARE REFORM Keys for Cost-effectiveness Robert E. Burke, MD; Eric A. Coleman, MD, MPH ospitals began paying financial penalties for high-risk–adjusted 30-day readmission rates for certain diagnoses in October 2012. Physician leaders seeking to reduce re- admission rates will find that proven interventions often require substantial up- H front financial and organizational investment. To reduce readmissions while mini- mizing the investment, leaders need to develop new and creative strategies guided by the evidence. This article describes 5 proposed strategies or “best practices” derived from critical evaluation of prior interventions and experience in the field. These practices include matching the intensity of the intervention to the patient’s risk of readmission, avoiding commonly used but unproven in- terventions, using interventions with a durable effect, creating an effective team before selecting an intervention, and focusing on previously unrecognized high-risk patient groups. JAMA Intern Med. 2013;173(8):695-698. Published online March 25, 2013. doi:10.1001/jamainternmed.2013.171 Hospitals were assessed the first round of successful interventions is their “high- financial penalties for high-risk–adjusted touch” nature. These high-touch inter- 30-day readmission rates for congestive ventions require substantial up-front in- heart failure (CHF), chronic obstructive vestment in personnel, training, and pulmonary disease (COPD), and pneumo- coordination of
JAMA Internal Medicine – American Medical Association
Published: Apr 22, 2013
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