Hospital-Wide All-Cause Unplanned Readmission Measure

Identifying Attributes

Care Settings
Care Transitions
Country
United States of America
Publishing Organisation
Centers for Medicare & Medicaid Services (CMS): Bundled Payment for Care Improvement Advanced Model
Type of Quality Indicator
Outcome
IOM Quality Dimension
Effectiveness
Domain
Hospitalisation

Defining Attributes

Definition

Hospital-wide all-cause unplanned readmission rate.

Numerator

Individuals in the denominator who have a readmission for any cause, except for certain planned readmissions, within 30 days from the date of discharge from an eligible index admission. If a Medicare beneficiary has more than one unplanned admission (for any reason) within 30 days after discharge from the index admission, the measure only counts as one readmission. Note that readmissions do not have to be at the same hospital location as the index admission

Denominator

All Medicare fee-for-service (FFS) beneficiaries aged 65 years and older who are hospitalised and are discharged alive from a Medicare-participating ACH. These Medicare FFS beneficiaries must have 12 months of continuous Medicare Part A enrolment prior to the index admission. Index admission refers to the first admission.

Exclusions

The exclusions for this measure include patients: • admitted to Prospective Payment System-exempt cancer hospitals • without at least 30 days post-discharge enrolment in Medicare FFS • discharged against medical advice • admitted for primary psychiatric diagnoses • admitted for rehabilitation • admitted for medical treatment of cancer

Use of Risk Adjustment
Yes
Risk Adjustments
Stratifications

Collection and Reporting Attributes

Type of Data Collection
Administrative data
Data Collection Methods

Claims Data

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

Not on CMS Care Compare

Reporting Frequency
Reporting Frequency in Days
Indicator Has Recommended Targets
No

Source and Reference Attributes

Technical Specifications
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
No
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
02 December 2025