Under value-based healthcare and the 2012 Hospital Readmission Reduction Program, healthcare organizations are more motivated than ever to reduce their incidence of preventable readmissions. Health systems can reduce risk of hospital readmissions by developing readmission risk scores tailored specifically to their populations. A risk model that meets the following five requirements will have significant predictive value and is most likely to achieve systemwide adoption:
- Identifies at-risk patients early.
- Separates patients relevant to the disease-specific identification method and intervention strategy from all other in-hospital patients.
- Uses organization-specific data to train a disease-specific model.
- Exceeds performance of existing models.
- Is developed in collaboration with domain experts.