Evaluating whether changes in utilization of hospital outpatient services contributed to lower Medicare readmission rate.

Objective: Descriptive analysis comparing changes in hospital inpatient readmissions to emergency department visits and observation stays that occurred within 30 days of an inpatient stay.

Population: Medicare fee-for-service (FFS) beneficiaries that had at least one acute hospital inpatient stay.

Data Source: Using 100 percent of claims in the Chronic Condition Data Warehouse, we compare growth in annual readmission stays to post-hospitalization emergency department visits and observation stays that were not accompanied by an inpatient stay.

Leveraging the big-data revolution: CMS is expanding capabilities to spur health system transformation.

As the largest single payer for health care in the United States, the Centers for Medicare and Medicaid Services (CMS) generates enormous amounts of data. Historically, CMS has faced technological challenges in storing, analyzing, and disseminating this information because of its volume and privacy concerns. However, rapid progress in the fields of data architecture, storage, and analysis--the big-data revolution--over the past several years has given CMS the capabilities to use data in new and innovative ways.

Medicare readmission rates showed meaningful decline in 2012.

Objective: Descriptive analysis of 30-day, all-cause hospital readmission rate patterns from 2007-2012.

Population: Medicare FFS beneficiaries experiencing at least one acute inpatient hospital stay.

Methods: Using Chronic Condition Data Warehouse claims, we estimate unadjusted, monthly, readmission rates for the nation, within the Dartmouth Hospital Referral Regions (HRR), and compare participating and non-participating hospitals in the Partnership for Patients (P4P) program (overall and by number of inpatient beds at each facility).