The Race for Readmission Reduction: Primary Care Follow-ups Reduce Debility Readmissions after Acute Inpatient Rehabilitation

Background: In 2012, the Centers for Medicare and Medicaid Services began to reduce payments to qualifying hospitals for 30-day readmission rates that were higher than predicted for specific diagnoses. The process was broadened to include skilled nursing facilities in 2018. It is reasonable to expect future expansion will include acute inpatient rehabilitation facilities. A pre-intervention quality improvement project from 2017 identified that patients admitted to an acute inpatient rehabilitation facility (IRF) for the primary diagnosis of debility were readmitted within 30 days of discharge at a rate of 38%, which was nearly three times higher than the next most readmitted diagnosis. A literature review identified rapid primary care provider (PCP) outpatient follow up as a worthy intervention to reduce readmissions. Objectives: Over a six-month intervention period, we attempted to achieve a reduction in 30-day readmission rates in the debility population of an IRF by scheduling PCP follow-ups within seven business days after discharge. Results: Of those that received the intervention, 7% were readmitted (P=0.018). Of those who did not receive the intervention, 56% were readmitted. Conclusion: The adoption of PCP follow-up within seven business days of discharge may lower the 30-day readmission rate for patients admitted to IRF with a primary diagnosis of debility.