Medicaid Readmissions Cost $77 Million Per State

In the health care industry’s quest to lower avoidable hospital readmission rates, recent findings by state Medicaid Medical Directors (MMD) now highlight the high costs — and prevalence — of Medicaid readmissions.

The 30-day Medicaid readmissions rates for 19 participating states varied, but accounted for an average of 9.4% of all admissions, according to MMD analysis. Readmissions represented 12.5% of Medicaid payments for all hospitalizations and averaged $77 million per state. 

These readmissions were driven by five diagnostic groups that made up 57% of readmissions and 49% of hospital payments for readmissions. The most prevalent diagnostic groups were mental and behavioral disorders; pregnancy, childbirth and their complications; and diseases of the respiratory, digestive and circulatory systems. Mental and behavioral disorders and diagnoses related to pregnancy, childbirth and their complications together accounted for 31.2% of readmissions.

This analysis allows Medicaid medical directors to better understand the nature and prevalence of hospital use in the Medicaid population and provides a baseline for measuring improvement.

Read an abstract of the analysis here

Written by Emily Study

Emily Study