Hospitals are being penalized by Medicare and Medicaid for hospital readmissions — through lower reimbursement — since co-existing psychiatric conditions often contribute to why patients are readmitted.
The issue of readmission rates is of importance to hospitals given that in October 2012, the Centers for Medicare and Medicaid Services (CMS) linked readmission rates to reimbursement those facilities would receive from the U.S. government. The policy was implemented to curtail rising health care costs.
Under the CMS policy, three medical conditions — heart failure, acute myocardial infarction and pneumonia — were chosen as ways of assessing excessive re-hospitalization, according to Brian K. Ahmedani, PhD, a researcher with the Henry Ford Health System’s Center for Health Policy and Health Services Research.
In a new study he led, Ahmedani and colleagues identified more than 160,000 patients who had been admitted to the 11 Mental Health Research Network-affiliated health centers between January 2009 and December 2011 for any of the three conditions identified by CMS.
Data showed that patients with psychiatric comorbidities in the prior year were readmitted to the hospital 3 to 5% more often within 30 days than those without a mental illness diagnosis, the researchers reported in the journal Psychiatric Services.
In addition, 30% of patients admitted to the hospital with one of the three medical ailments was diagnosed in the previous year with a mental illness.
“Because depression, anxiety and substance abuse appeared to be the most common diagnoses among the patients we studied, and because each was associated with increased readmission rates, these disorders may be the most appropriate for health care systems to focus their primary screening efforts,” Ahmedani said in a statement.
The authors concluded that individuals with psychiatric conditions probably account for more than 30% of readmissions since such conditions are often not diagnosed.
Ahmedani BK, et al. Psychiatric Comorbidity and 30-Day Readmissions After Hospitalization for Heart Failure, AMI, and Pneumonia. Psychiatr Serv. 2015; 66(2):134-140.