Having to return to the hospital for another round of treatments for the same medical condition isn't just emotionally draining, potentially dangerous and tough on a patient's wallet. It also costs hospitals a ton of money, according to a report issued today.
A typical hospital with 200 to 300 beds wastes up to $3.8 million a year, or 9.6 percent of its total budget, on readmissions of patients who shouldn't have had to come back, says Premier, a health care company that advises hospitals on improving efficiency and safety. The company analyzed the records of 5.8 million incidents in which a patient went back to a hospital to be re-treated and found they added $8.7 billion a year, or 15.7 percent, to the cost of caring for those people.
Cutting back on these readmissions would be good news for patients. Even if the hospital has to eat the costs of additional treatments, patients are still subject to the risks of the procedures they undergo and the normal danger of contracting an infection while in the hospital. Patients being treated for heart attacks, respiratory problems like pneumonia and major joint problems are the most likely to wind up back in the hospital, according to Premier.
Wasteful spending in the U.S. health care system has been estimated to be as high as $850 billion each year, according to a 2009 Thomson Reuters report. Overall health care spending rose by a factor of 10 between 1980 and 2010, when it reached $2.6 trillion.
Hospitals are ground zero for health care cost-containment efforts because they are the biggest recipients of America's health care spending, having taken in $814 billion in 2010, according to a federal government report. Rising costs and shrinking payments from government programs like Medicare and Medicaid and from private insurance companies have hospitals looking everywhere for ways to streamline their operations.
The health care reform law enacted two years ago expands on efforts begun three years ago to link how much Medicare pays hospitals to how well they reduce medical errors, readmissions, and other inefficiencies. Starting next year, hospitals will see their Medicare payments docked by 1 percent if they don't cut back on these readmissions. The penalty increases to 3 percent in 2015.
Premier's message to hospitals feeling squeezed: The money you need to save is already in the system. The company has identified 15 steps hospitals can take to improve the care they provide while also saving money, such as making sure patients are treated right the first time and don't need to be "readmitted" for more care. By analyzing information culled from its hospital partners, Premier recommends other targets for savings, such as performing fewer blood transfusions and limiting costly tests.
Major physician groups also recently rolled out an initiative to reduce unnecessary medical tests. Combined with efforts such as those promoted by Premier, these ventures underscore how private sector health care entities are accelerating cost-containment programs with a push by the health care reform law.
CORRECTION: An earlier version of this story stated that Premier is a nonprofit company. Premier is a for-profit company that works with nonprofit hospitals.