Hospital readmissions carry significant financial costs and are associated with negative patient outcomes. While the reasons behind patient readmissions are multi-factorial, and the specific rates vary by institution, nearly 20 percent of all Medicare discharges nationwide led to a readmission within 30 days. Preventing even 10 percent of these readmissions could save Medicare $1 billion.
North Carolina’s only not-for-profit, independent community healthcare system, Mission Health, is comprised of seven hospitals, 750 employed/aligned providers, and one of the largest Medicare Shared Savings ACOs in the nation. Mission had been using the LACE index to predict risk for readmission, and while it was helpful, Mission’s patient population was different than the population used to develop the LACE index, leaving the health system with some uncertainty regarding the readmission risk of its patients. With the help of data analytics, Mission developed its own predictive model for assessing readmission risk, aimed at preventing readmissions and improving outcomes for patients.
The area under the curve (AUC) for Mission’s readmission risk predictor is 0.784, outperforming LACE, and meeting the organization’s goal for performance.
Mission’s readmission rate is 1.2 percentage points lower than its top hospital peers.