Readmissions

Do you have a stack of journals piling up on your desk, beside your bed or in your email inbox? In 1950, medical knowledge was estimated to double every 50 years, but now the doubling time is every few months. At this rate, it is impossible to keep up with the literature, but a group […]

I distinctly remember my first stint on night float rotation — it did not come until I was a third-year resident since most of my rotations were pre-duty hours. It was a “novel innovation” in our program and the job seemed simple — admit overnight, handoff to the day team, go home and sleep. Get […]

By: Moises Auron, MD, SFHM It is a well-known fact that healthcare expenditure in the United States occupies a large proportion of its gross domestic product, being 17.8% in 2016, which was almost twice to what is expended in other advanced countries; however, this expenditure does not necessarily translate into optimal patient outcomes. In 2012, […]

There is at least one aspect of “Obamacare” that my mother-in-law and I can firmly agree on: hospitals should not get paid for frequent readmissions. The Hospital Readmission Reduction Program (HRRP), enacted by the Centers for Medicare and Medicaid Services (CMS) in 2012 with the goal of penalizing hospitals for excessive readmissions, has great face […]

Public and private payers incentivizing providers (P4P) to coax desired clinical behaviors have failed. Both CMS derived measures and those used by commercial insurers, many of which overlap, fail to pass Good Housekeeping standards and lack the reliable characteristics indicators must possess. Whether those indicators are valid, attributable, or meaningful makes all the difference in […]

By: Jennifer K. Chen, MD, pediatric hospital medicine fellow at Rady Children’s Hospital, UC San Diego I first heard the term “discharge before noon” (DCBN) as a third-year medical student starting my internal medicine rotation. The basic idea made sense: get patients out of the hospital early so rooms can be cleaned more quickly and […]