Hospital readmissions is a topic that reached the national health reform debate in 2010 and remains in the forefront as an area for potential cost reduction. Fueled by the 2009 New England Journal of Medicine article that reported about 20 percent of hospitalized Medicare patients were readmitted within 30 days of hospital discharge, policy makers have introduced financial penalties to hospitals that experience readmissions in Medicare patients. While these penalties currently apply only to patients with heart attack, pneumonia, or heart failure procedures, CMS will likely add to this list of diagnoses in the future. Additionally, as has been the case in the past, where CMS goes, other insurers follow. It is therefore incumbent on hospitals to make sure that they are prepared for the reimbursement consequences of what are perceived to be unnecessary readmissions, and more importantly, that they are acting to reduce the number of readmissions that can be avoided.

To assist West Virginia hospitals in understanding their readmissions and reducing their numbers, where appropriate, the West Virginia Health Improvement Institute sponsored a rapid-cycle readmission collaborative in partnership with the WV Hospital Association, the Bureau for Medical Services, and the WV Health Care Authority. This collaborative included an initial learning session in March 2011, monthly calls with participating hospitals, and a final sharing summit in September, 2011. Content provided to the hospitals included change concepts demonstrated effective in national initiatives. This includes standardizing the discharge process, assessment upon admission, effective patient and family teaching, real-time communication and handoff information, and post-discharge follow-up. The final sharing session introduced the concept of involving stakeholders outside the hospital in the efforts to reduce avoidable readmissions. Twenty of West Virginia’s hospitals participated in the Collaborative by reporting their readmission rates, implementing various interventions, and sharing their successes at the September sharing session.