Hospital-Wide, 30-Day, All-Cause Unplanned Readmission Rate for the Merit-Based Incentive Payment Program Groups

Identifying Attributes

Care Settings
Care Transitions
Country
United States of America
Publishing Organisation
Centers for Medicare & Medicaid Services (CMS): Merit-Based Incentive Payment System Program
Type of Quality Indicator
Outcome
IOM Quality Dimension
Effectiveness
Domain
Hospitalisation

Defining Attributes

Definition

Risk-adjusted readmission rate of unplanned readmission within 30 days of hospital discharge for any condition, developed for patients 65 years and older using Medicare claims.

Numerator

Unplanned all-cause 30-day readmission. Readmission is defined as a subsequent inpatient admission to any acute care facility which occurs within 30 days of the discharge date of an eligible index admission. Any readmission is eligible to be counted as an outcome.

Denominator

Patients with an index admission hospitalisation to which the readmission outcome is attributed and includes admissions for patients: aged 65 or over; discharged alive; and not transferred to an acute care facility.

Exclusions

Numerator: planned readmissions Denominator: Patients discharged against medical advice; Admissions for patients to a PPS-exempt cancer hospital; Admissions primarily for medical treatment of cancer; Admissions primarily for psychiatric disease; Admissions for "rehabilitation care; fitting of prostheses and adjustment devices"; Admissions where patient cannot be attributed to a clinician group.

Use of Risk Adjustment
Yes
Risk Adjustments
Stratifications

Data Attributes

Type of Data Collection
Administrative data
Data Collection Methods

Claims Data.

Frequency of Data Collection
Annually
Frequency of Data Collection in Days
365
Reporting Methods

Merit-Based Incentive Payment System Program (CMS and Providers) CMS Provider Compare - Doctors & Clinicians (Publicly reported).

Reporting Frequency
Annually
Reporting Frequency in Days
365
Indicator Has Recommended Targets
No

Source and Reference Attributes

Link to Measurement Tools
Quality Indicator Confirmed to be Part of a Program Used to Monitor Quality and Safety of Care Among Older People at a Population-Level between 2012-2022
Yes
Assessed by the Australian Consortium for Aged Care Collaborators as Generally Containing Good Properties (Importance and Scientific Acceptability)
No
Australian Consortium for Aged Care Endorsed
No
Identified by PHARMA-Care Project
No
Upload Date
12 March 2025