Reducing excess readmission 101: evidence-driven strategies and facility-specific initiatives

Healthcare cost-reduction strategies are continuously being researched and implemented by healthcare institutions, public and private healthcare payer organizations, and healthcare oversight and research institutions. Reducing hospital readmissions is an appealing and viable intervention. This article differentiates avoidable from unavoidable (excess) readmissions and explains two metrics: Excess Readmission (XR RA) and Payments for Excess Readmission Ratios used by the Centers for Medicare & Medicaid Services to quantify and trend excess readmissions and impact of associated penalties. This article categorizes potential interventions on the basis of timing in the course of an admission when they can be implemented, reviewing evidence for and against each intervention. The authors also describe the initiatives at a community hospital aimed at reducing excess readmissions.