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Sepsis Counts for More Readmissions, Costs than CMS’s Four Medical Conditions Tracked for Readmission Rates

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Sepsis accounts for considerably more hospital readmissions and associated costs than any of the four medical conditions tracked by the federal government to measure quality of care and guide pay-for-performance reimbursements, according to an analysis led by the University of Pittsburgh School of Medicine and VA Pittsburgh Healthcare System. The findings, published in the Journal of the American Medical Association, highlight the need for coordinated efforts to develop new medical interventions aimed at improving sepsis outcomes and reducing readmissions. The Centers for Medicare & Medicaid Services currently tracks readmissions for four medical conditions: heart attack, heart failure, chronic obstructive pulmonary disease (COPD) and pneumonia. A key component of the Affordable Care Act, the Hospital Readmission Reduction Program, penalizes hospitals if they have excessive rates of readmissions for these conditions. Researchers analyzed data from the 2013 Nationwide Readmissions Database, which comprises 49 percent of U.S. inpatients, for the four conditions and sepsis. They revealed that sepsis accounts for 12.2 percent of readmissions, followed by 6.7 percent for heart failure, 5 percent for pneumonia, 4.6 percent for COPD and 1.3 percent for heart attack.  Sepsis also costs more. The estimated average cost per readmission for sepsis was $10,070, compared to $9,533 for pneumonia, $9,424 for heart attack, $9,051 for heart failure and $8,417 for COPD.

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