Table 3.
Condition-specific expected net earnings (Medicare reimbursement revenue gains net of program costs) from an investment in a readmission reduction program, by applicable condition.
| AMI (n=937) |
HF (n=1,409) |
COPD (n=1,356) |
PN (n=1,409) |
THA/TKA (n=718) |
|
|---|---|---|---|---|---|
| Panel 1: Expected readmission
reduction = 5%; Expected intervention cost = $130 per-discharge | |||||
| Mean | 82,427.02 | 64,325.07 | 42807.83 | 47130.07 | 183566.3 |
| 95%CI | 76,227.78 88,626.26 | 59,604.31 69,045.8 | 39,335.77 46,279.88 | 43,822.46 50,437.67 | 169,490.8 197,641.7 |
| IQ Range | 82,13.45 121,356.12 | 60,457.32 90,004.5 | 36,549.56 71,450.56 | 45,482.12 62,145.36 | 169,458.3 230,456.3 |
| n/N (%) | 779/937 (83.1) | 1140/1409 / (80.9) | 1018/1356 (75.1) | 1070/1409 (75.9) | 606/718 (84.4) |
|
Panel 2: Expected
readmission reduction = 5%;
Expected intervention cost = $325 per-discharge | |||||
| Mean | 25,560.28 | −28,496.73 | −35,793.14 | −27,369.07 | 88,137.39 |
| 95%CI | 21,214.21 29,906.34 | −31,955.3 −25,038.09 | −38,553.1 −33,033.17 | −29,791.26 −24,946.88 | 77,523.07 98,751.71 |
| IQ Range | 21,023.83 32,189.23 | −30,145.25 −10,561.78 | −32,145.39 −23,128.96 | −30,458.36 −25,458.23 | 78,567.91 110,236.96 |
| n/N (%) | 670/937 (71.5) | 303/1409 (21.5) | 125/1356 (9.2) | 215/1409 (15.3) | 549/718 (76.5) |
|
Panel 3: Expected
readmission reduction = 10%; Expected intervention cost = $130 per-discharge | |||||
| Mean | 174,597.6 | 149,834.1 | 112,281 | 118,865.8 | 397,370.7 |
| 95%CI | 19,844.04 20,742.51 | 139,388.9 160,279.3 | 104,325.5 120,236.5 | 111,605 126,126.6 | 366,836.6 427,904.8 |
| IQ Range | 19,568.21 28,125.42 | 130,458.3 175,128.2 | 105,563.1 128,236.9 | 111,230.2 139,123.2 | 360,428.2 450,254.5 |
| n/N (%) | 800/937 (85.3) | 1165/1409 (82.7) | 1071/1356 (79.0) | 1133/1409 (80.4) | 644/718 (89.7) |
|
Panel 4: Expected
readmission reduction =10%;
Expected intervention cost = $325 per-discharge | |||||
| Mean | 117,730.8 | 57,012.33 | 33,680.03 | 44,366.68 | 301,941.8 |
| 95%CI | 20320.74 21249.02 | 48794.75 65229.92 | 27412.27 39947.78 | 38521.00 50212.36 | 274941.7 328942.00 |
| IQ Range | 19,124.47 24,236.5 | 48120.32 71,156.28 | 27,189.23 42,458.36 | 36,458.90 55,458.26 | 461,125.9 350,488.9 |
| n/N (%) | 794/937 (77.3) | 950/1409 (67.4) | 853/1356 (62.9) | 927/1409 (65.8) | 570/718 (79.4) |
The table presents results of a pro forma analysis of expected net earnings from each of the applicable conditions, following a hypothetical readmission-reduction intervention, under four permutations of assumptions regarding the effectiveness and costs of the intervention. Shown are the means, 95% CIs and interquartile (IQ) ranges of the expected net earnings on Medicare discharges for each condition, and the number and percent of hospitals that are expected to see positive net earnings for that condition. Numbers in red represent negative net earnings (the cost of the intervention is expected to exceed the projected Medicare reimbursement revenue gain).