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Nearly 20% of Medicare beneficiaries are rehospitalized within 30 days of discharge. Such readmissions account for more than US$17 billion annually in Medicare expenditures. The Centers for Medicare and Medicaid Services (CMS) recently began penalizing hospitals financially (as much as 2% of all Medicare admission payments) when they have higher-than-expected 30-day readmission rates. This practice has stimulated greater quality-improvement (QI) efforts to prevent readmissions, but initial results show variable effectiveness and raise concerns about generalizability (Ann Intern Med 2011; 155:520).
Researchers examined the effect of a structured QI implementation effort in 11 of 30 hospitals participating in the Better Outcomes by Optimizing …