National COPD Readmissions Summit 2013: Integrating COPD into Patient-Centered Hospital Readmissions Reduction Programs

Abstract

About 1 in 5 patients hospitalized for exacerbations of chronic obstructive pulmonary disease (COPD) in the United States are readmitted within 30 days. The U.S. Centers for Medicare and Medicaid Services has recently expanded its Hospital Readmissions Reduction Program to financially penalize hospitals with higher than expected all-cause 30-day readmission rates following a hospitalization for COPD exacerbation. In October 2013, the COPD Foundation convened a multi-stakeholder National COPD Readmissions Summit to summarize our understanding of how to reduce hospital readmissions in patients hospitalized for COPD exacerbations. Over 225 individuals participated in the Summit, including patients, clinicians, health service researchers, policy makers and representatives of academic health care centers, industry, and payers. Summit participants recommend that programs to reduce hospital readmissions: 1) Include specific recommendations about how to promote COPD self-management skills training for patients and their caregivers; 2) Adequately address co-existing disorders common to COPD in care plans during and after hospitalizations; 3) Include an evaluation of adverse events when implementing strategies to reduce hospital readmissions; and 4) Develop a strategy (e.g., a learning collaboratory) to connect groups who are engaged in developing, testing, and implementing programs to reduce hospital readmissions for COPD and other conditions.

Discharge disposition as an independent predictor of readmission among patients hospitalised for community-acquired pneumonia

“…4 As a result of this financial incentive, hospitals across geographic regions have been implementing programmes directed at reducing readmissions among patients with COPD. 25 Likely as a result of this, Medicare data has shown that readmission rates among COPD patients have declined markedly since 2012. 26 While studies prior to 2012 showed a positive association between pulmonary disease and readmission risk, 6,19 we believe these CMS incentives underlie the reduced risk of readmission we observed.…”

“…During the period of analysis, CMS’ Hospital Readmission Reduction Program began imposing financial penalties for excess readmissions among COPD patients and other common medical conditions . As a result of this financial incentive, hospitals across geographic regions have been implementing programmes directed at reducing readmissions among patients with COPD . Likely as a result of this, Medicare data has shown that readmission rates among COPD patients have declined markedly since 2012 .…”

Further Evidence on the System‐Wide Effects of the Hospital Readmissions Reduction Program

“…; Hanes ; Krishnan et al. ). Some of these strategies, such as improved discharge planning, better care coordination, and enhanced patient education may be applied generally (noncondition‐specific) and scaled across condition categories with relative ease.…”

Impact and prevention of severe exacerbations of COPD: a review of the evidence

“…Despite best efforts, many readmissions may not be preventable. The US National COPD Readmissions Summit, as well as a recent systematic review, found that the evidence base to support specific interventions that would significantly reduce 30-day readmission rates in patients hospitalized for COPD exacerbations was inadequate 163,164…”