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Risk-Adjusted 30-Day All-Cause Readmission Rate

CBE ID
0329
Endorsement Status
1.1 New or Maintenance
Previous Endorsement Cycle
Is Under Review
No
1.3 Measure Description

The existing NQF-endorsed measure provides a means for determining the risk-adjusted readmission rate for a selected adult target population and can be applied for any desired timeframe. Readmission rate is defined as the percentage of acute inpatient discharges during the measurement period followed by an acute inpatient admission for any diagnosis to any hospital within 30 days

We are proposing to change the measure and offer a risk factor approach. This method allows for calculation of a risk-adjusted readmission rate for use in two different ways: 1) retrospective analysis of hospital (or other study population) performance determination and 2) in a real-time Electronic Health Record (EHR) environment, analysis to determine the readmission risk factor for each inpatient admission.

        • 1.14 Numerator

          Non-behavioral health acute inpatient admissions for patients who were readmitted following a discharge from a non-behavioral health acute inpatient admission (index admission).

        • 1.15 Denominator

          The denominator contains all eligible non-behavioral acute care inpatient discharges for the target population being measured for the desired measurement period. A patient can have multiple eligible discharges during the measurement period.

        • Exclusions

          The cases to be excluded from the denominator are those for patients who died during the hospital stay or were hospitalized for mental health disorders or substance abuse treatment.

        • Most Recent Endorsement Activity
          Measure Retired and Endorsement Removed Readmissions Endorsement Maintenance Project
          Initial Endorsement
          Last Updated
          Removal Date
        • Steward
          United Health Group
          Steward Organization POC Email