May 4, 2023
According to the Centers for Medicare & Medicaid Services, readmission to the hospital within 30 days of discharge can lead to adverse patient outcomes and higher costs, and is frequently avoidable.
The Plan All-Cause Readmissions (PCR) HEDIS® measure assesses the percentage of acute inpatient and observation stays that were followed by an unplanned acute readmission for any diagnosis within 30 days. This is compared to the predicted probability of an acute readmission to obtain an observed-to-expected ratio. This measure returned to CMS Star Ratings in 2022 and is triple weighted for measurement year 2023.
Coordinating care from the hospital to home and ensuring a follow-up visit with the primary care physician can help your patients avoid a readmission.
Review the PCR tip sheet to learn more about this measure, including information about exclusions, best practices, and tips for success while talking with patients.
For more information, contact ProviderClinicalConsulting@Premera.com.
Healthcare Effectiveness Data Information Set (HEDIS®) is a registered trademark of the National Committee for Quality Assurance (NCQA).