Funder: Kaiser Permanente

Author: Todd Gilmer, University of California San Diego, and Allison Hamblin, Center for Health Care Strategies, Inc.

December 2010 | Brief

Preventing unnecessary hospital readmissions among Medicaid beneficiaries offers tremendous potential for states to improve health care quality and control spending. This Faces of Medicaid data brief examines readmission rates among Medicaid beneficiaries with disabilities and identifies new opportunities to reduce recurring hospitalizations.

The analysis, by Todd Gilmer, PhD, at the University of California, San Diego, focuses on Medicaid beneficiaries with disabilities through a variety of lenses: by number and type of chronic conditions; by state; and by whether or not beneficiaries had a physician visit between discharge and readmission. Select findings reveal:

  • The 30-day readmission rate for Medicaid beneficiaries with disabilities was 16 percent, rising to 53 percent within one year.
  • Fifty percent of those readmitted within 30 days did not visit a physician between discharge and readmission.
  • The likelihood of readmission increased with the number of chronic conditions.

The findings highlight the need for targeted activities to reduce avoidable readmissions, particularly for populations at greatest risk for readmission. With great attention being paid to readmissions nationally, this analysis offers new insights to help Medicaid stakeholders identify critical opportunities for intervention.

This analysis, made possible by Kaiser Permanente, is part of CHCS’ Faces of Medicaid data series designed to help Medicaid stakeholders identify subsets of patients or conditions that are most likely to benefit from care management. It is a product of CHCS’ Rethinking Care Program, which is developing and testing new strategies to improve health care quality and control spending for Medicaid’s highest-need, highest-cost populations.