How Home Health Can Win the Readmissions Numbers Game

Home health agencies might succeed in reducing hospital readmissions if they think of it as a numbers game.

In fact, the number of home health visits during the first week post-discharge may play a critical role in readmission rates of Medicare beneficiaries, according to Zeb Clayton, vice president of client services at Santa Barbara, California-based health care data analytics and benchmarking firm Strategic Healthcare Programs (SHP).

“Doing more than one visit in that first seven days is a huge factor in reducing readmission rates,” Clayton explained during a May 24 Home Health Care News webinar sponsored by post-acute software provider Optima Healthcare Solutions.

When just one home health visit occurs in the first week post-inpatient discharge, the readmission rate averages 36.4% nationally, SHP’s data show. When two home health visits occur, the average readmission rate falls to 15.5%; when three visits occur, the average readmission rate falls to 11.4%.

Screen Shot 2017 05 24 at 3 15 17 PM

“Getting to at least three visits in those first seven days is going to be critical,” SHP Vice President of Business Intelligence Chris Attaya said during the webinar.

The amount of time that lapses between an inpatient discharge and the first home health visit also influences readmission rates, data show.

When four days pass between an inpatient discharge and the start of home health care, the readmission rate is 13.3%, Clayton said. When only three days pass, the readmission rate falls to 12.9%; when one day passes, the readmission rate is 12.1%.

Screen Shot 2017 05 24 at 1 33 13 PM

The readmission rate for patients whose first home health visit occurs on the same day that they are discharged may be higher the readmission rate for patients whose first home health visit occurs one, two, three, four or five days after discharge due to a patient’s higher acuity, Clayton added.

Stacking the deck

The specific day of the week a Medicare patient is discharged from inpatient care may impact in his or her chances of readmission, SHP’s data show.

“Interestingly, by quite a margin, Monday and Tuesday discharges tend to have the highest readmission rate,” Clayton explained, citing fiscal year 2016 data.

Screen Shot 2017 05 24 at 3 19 04 PM

The type of home health care agency may also play a part in a patient’s chances of readmission.

At 12.1%, non-profit home health agencies had the lowest Medicare readmission rate between 2012 and 2016. The readmission rates for proprietary and governmental home health agencies during that period were 13.1% and 14.1%, respectively.

Written by Mary Kate Nelson