The Centers for Medicare & Medicaid Services (CMS) wants to address the racial and ethnic disparities in healthcare.
CMS’s Office of Minority Health released the Guide to Preventing Readmissions among Racially and Ethnically Diverse Medicare Beneficiaries, designed to improve quality of care and reducing avoidable readmission costs. Each year, 2 million Medicare patients are readmitted within a month of hospitalization, costing $26 billion. An estimated $17 billion comes from are potentially avoidable readmissions, according to the report.
Racial and ethnic minority populations are more likely than their white counterparts to be readmitted within 30 days of discharge for certain chronic conditions, including heart failure, heart attack, pneumonia, chronic obstructive pulmonary disease (COPD) and elective hip and knee replacements. These are the same conditions for which CMS has increased the maximum penalty for hospitals. Not surprisingly, since the enactment of the Hospital Readmission Reduction Program, hospitals that serve vulnerable and minority patient populations have been most heavily penalized.
"There has been extensive research and guidance on how to prevent avoidable readmissions, and the strategies span many areas and a myriad of initiatives," the guide authors write. "Less, however, has been done to effectively cross-walk the particular barriers minority and vulnerable populations face in this regard, and how they might be addressed in the context of broader plans to address readmission in the overall population."
The guide cited barriers related to limited English proficiency, health literacy and numeracy as well as issues of mistrust, poor social support and discomfort with self-engagement as contributing factors to higher readmission rates.
The guide, part of the CMS Equity Plan for Improving Quality in Medicare, was developed in collaboration with the Disparities Solutions Center at Massachusetts General Hospital and the National Opinion Research Center at the University of Chicago.
Read the guide here.