Home Health Agencies Protect Referrals by Cutting Hospital Readmissions

Home health agencies are outperforming the post-acute sector as a whole in preventing patient rehospitalizations, according to data released Wednesday by the Alliance for Home Health Quality and Innovation.

The numbers suggest that home health providers are taking steps to protect and expand their referral streams from hospitals, Alliance Executive Director Teresa Lee tells Home Health Care News. Since 2012, hospitals have faced Medicare reimbursement cuts if too many patients return within 30 days, meaning they are looking for post-acute providers that can help prevent readmissions.

Between 2011 and 2012, hospital readmissions from home health settings decreased about 2%, from 19.2% to 17.4%, according to the Alliance’s Chartbook report. For the post-acute sector overall, including skilled nursing and other provider types, the 2012 readmissions rate was 18.4%. These numbers were calculated for readmissions within 30 days of discharge, for the top 20 most common diagnosis groups sent to a post-acute setting.


Home health providers have taken a variety of steps to cut hospital readmissions, such as using checklists to ensure ongoing care coordination with the hospital after the patient has returned home.

Given the shifts in Medicare incentives, other types of providers also have sought to decrease rehospitalizations, and there has been a system-wide reduction, Lee notes.

“There is this overall trend, and we’re very pleased to see home health is part of that trend,” she tells HHCN.


Still, the fact that home health agencies are performing especially well on readmissions, coupled with the lower costs for home care versus facility-based care, could make HHAs particularly attractive partners for hospitals — particularly those that are part of accountable care organizations and similar provider groups that are financially rewarded for bringing down Medicare spending while meeting quality objectives.

“I hear anecdotally about agencies interacting with ACOs,” Lee says, noting that she does not have hard numbers on home health participation in ACOs. “It does seem to me that within the Alliance membership, there’s a great deal of engagement with ACOs, bundled payments, these different types of programs.”

Lee also points out that the percentage of patients who go from the hospital to home care has remained relatively stable over the past several Chartbook reports. However, she thinks it is reasonable to expect the proportion to increase in coming years. Medicare data does not immediately become available for analysis, so this shift might be underway well before it is reflected in an Alliance Chartbook report, she notes.

Click here to access the complete report, compiled for the Alliance by Avalere Health.

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