Home Health Readmission Numbers Keep Getting Better

Rehospitalization rates among Medicare patients from a home health setting are on the decline, and with an increased emphasis on coordination of care, the positive trend should continue, according to data recently updated by the Alliance for Home Health Quality and Innovation, a national non-profit consortium of home health care providers and organizations.

The Home Health Chartbook, compiled by Avalere Health LLC, summarizes and analyzes statistics on home health economic and demographic trends from various government sources. The latest data included in the Chartbook shows a steady decline in hospital readmission rates for home health users within 30 days of discharge for the top 20 most common diagnosis groups.

Specifically, the home health rehospitalization rate for Medicare patients decreased by nearly two percentage points, from 19.17% in 2011 to 17.39% in 2012. The data shows that trend is continuing, as the rate fell to 16.92% in 2013. Alliance Executive Director Teresa Lee attributes the decline to alternate models of health care delivery, such as the Accountable Care Organization program and bundled payments.

“The health care system has become much more attuned to the issue of readmission, and it’s starting to put in place programs that better support patients after they leave the hospital,” Lee tells Home Health Care News. “Home health is very much viewed as part of the solution.”

Supplemental data released by the Alliance depicts patient destinations after a hospital stay, and it suggests that post-acute settings widely vary at the state level.

More than half of Medicare patients discharged from a hospital stay in Connecticut received formal post-acute care, with 18% being in a home health setup. In Oregon, however, less than 40% of patients received formal post-acute care, with only 8% receiving such care at home, despite having a similar population as Connecticut.

The Chartbook also indicates that home health patients continue to be older, sicker and poorer than the general Medicare population. Home health users were twice as likely as typical Medicare beneficiaries to be over age 85, for example, and 85.1% had three or more chronic conditions. Further, 67.2% of home health users were at or under 200% of the Federal Poverty Level, versus 52.1% among the Medicare population as a whole.

“As the population ages, it’s a known and anticipated trend that we’re going to see patients with greater needs,” Lee tells HHCN. “It wouldn’t be surprising to see that into the future.”

The Chartbook unveiled a variety of other findings, including:

• Gender: About 61.5% of home health users were female in 2013, as compared to 54.6% of all Medicare beneficiaries. Meanwhile, males accounted for 38.5% of home health users and 45.4% of Medicare beneficiaries overall.
• Income and Race: Approximately 92.4% of Hispanic patients receiving in-home health care and 84.6% of black patients had an income under 200% the Federal Poverty Level in 2013, while 67.2% of all Medicare home health users had similar income levels.
• Mental Illness: More than a quarter of home health users had a severe mental illness including bipolar disorder, schizophrenia and depression, whereas 18.7% of all Medicare beneficiaries had such illnesses.

Written by Kourtney Liepelt