Quality Indicator Healthcare Quality Indicators

With the adoption of the Affordable Care Act, also now commonly referred to as Obamacare, the array of quality indicators used to assess healthcare facility performance has expanded. The addition of a number of quality indicators with direct connections to penalties and other punitive measures has created a great deal of pressure for hospitals and other healthcare facilities. Many of these quality indicators are designed to heighten accountability among hospitals and other acute healthcare treatment cites or systems. Among them, penalties for preventable readmissions has become an exceptionally prominent indicator of performance quality.

Quality Indicator:

According to Brink (2013), the quality indicator of readmission rates has become an important issue for healthcare leaders and hospital administrators. Brink reports that roughly 12% of all Medicare patients will be readmitted to the hospital within the first 30 days of discharge for recurrent conditions that could be prevented through better treatment and planning. The outcome of these preventable readmissions is an extremely costly burden on the healthcare system as well as a heightened health risk for those who are most vulnerable to readmission. Therefore,...

In fact, according to Brink, Medicare has issued more than $227 million in reimbursement penalties for the latest round of fines. (Brink, p. 1)
Rau (2013) reports that these penalties will only get higher as the program continues to advance. During the first phase of this initiative, penalties were capped at 1% of Medicare reimbursements. In the most recent round noted above, Rau reports that the number was capped at 2%. This cap will rise once again, to 3%, in the fall of 2014. (Rau, p. 1)

This economic pressure is driven by the perspective that readmission rates are a useful quality indicator for understanding exactly how hospitals are performing with respect to patient needs. To the point, Johnson points out that the health risks of unnecessary or preventable hospitalization are significant on their own. Hospitalization heightens the vulnerability of a patient to infection, falls and the decline of both physical and cognitive function. (Johnson, p. 1) In addition to the financial imperatives for preventing unnecessary readmissions, there is an understanding that there are also strong health imperatives in play.

Action Plan:

Developing an action plan for the prevention of readmissions is a challenge that most hospitals are currently wrestling with. For many hospitals, a key…