AJMC October 4, 2021
Jason Z. Rose, MHSA

The 2022 performance year’s Star Ratings require Medicare Advantage plans to take a more significant role in preventing readmissions.

Transitions of care have become a major focus for improving health care quality and patient experience and reducing hospital readmissions. The ineffective transferring of a patient from one care setting (eg, a hospital, nursing facility, primary care physician, long-term care, home health care, specialist care) to another often leads to confusion about treatment plans, missed follow-up appointments, patient dissatisfaction, medication nonadherence, and, most importantly, unnecessary readmissions.

Nearly one-fifth (19.6%) of Medicare patients discharged were readmitted within 30 days and 34.0% were readmitted within 90 days. These readmissions cost Medicare $17.4 billion annually. Reports indicate that up to 40% of all medication...

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Topics: CMS, Govt Agencies, Health System / Hospital, Insurance, Medicare Advantage, Payer, Provider
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