Cheaper home healthcare causes higher readmission rates, study says

By Tauren Dyson

March 13 (UPI) -- Cutting costs isn't always the best move, especially when it comes to healthcare, a new study says.

Medicare patients discharged to home healthcare had nearly a 6 percent higher risk of returning to a hospital after 30 days than those discharged to post-acute care nursing facilities, according to a study published Monday in JAMA Internal Medicine.


"With the increasing costs of post-acute care and changing payment models that hold providers more accountable for costs across clinical settings, it's important to assess and understand the impacts of these choices," said Rachel Werner, who runs the Health Policy and Outcomes Research center at University of Pennsylvania and study first author, in a news release.

When the Affordable Care Act launched, it reformed Medicare by incentivizing the reduction of patient readmission rates. This led hospitals to discharge more patients to skilled nursing facilities, which have been shown to reduce readmission rates.

At the same time, accountable care organizations and bundled payments began to pop up, encouraging patients to explore lower-cost options like home care instead of pricier nursing facilities.

Between 2010 and 2016, patients who received home care after being discharged from a hospital paid $5,384 less than people those who went to nursing facilities.


For Medicare patients, payments were $4,514 less if they were discharged to home care versus those sent to skilled nursing facilities.

But sometimes lower costs are not always a good thing.

About 40 percent of patients facing early readmission following heart failure surgery because of low-quality home care, according to one study.

"We found clear tradeoffs: While home health care may cost less, it doesn't have the same intensity of care as a skilled nursing facility, which may be sending many of them back into the hospital," Werner said.

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