The Reality of Medicare Patient Readmissions

A shocking study featured in the New England Journal of Medicine revealed that one in five Medicare patients are readmitted to the hospital within 30 days of being discharged, and one in three return within 90 days. These alarming numbers are primarily due to patients lacking a primary care provider. More than half of the nonsurgical patients studied had not seen a doctor before being re-hospitalized.

While these statistics are unsettling, I question the identified causes and proposed solutions. Healthcare has lagged significantly behind other industries in adopting quality, Lean and Six Sigma methodologies, resulting in spiraling costs and compromised patient care.

Applying Six Sigma and Lean Manufacturing in Healthcare

The healthcare sector’s costs continue to skyrocket, consuming an increasingly larger share of GDP, with patients suffering the consequences. Hospital readmissions are the healthcare equivalent of manufacturing field failures. If any manufacturer had failure rates like this, they’d be out of business within months.

Earlier posts reported that hospitals inadvertently cause an estimated 98,000 deaths per year, with some estimates double that number. This is the equivalent of a jumbo jet crashing daily, killing all 400 passengers. Even patients who leave the hospital alive are very likely to return soon after discharge, highlighting the systemic failures of the healthcare system both inside and outside hospital walls.

While healthcare providers continue to profit from fixing problems they either caused or could have prevented, society is bearing an unsustainable cost. This grim situation needs to change, and Six Sigma and Lean Manufacturing methodologies offer the potential for transformative improvements.

Six Sigma: A Solution for Readmission Rates

Data from a recent study demonstrates the potential for Six Sigma in healthcare. A simple process change reduced the readmission rate for Medicare Med Surg patients from 28% to 10% in less than a year. Consequently, admissions per thousand insured members dropped from nearly 230 to around 120.

Yet, how do hospitals interpret this data – as an incredible accomplishment or lost revenue? We must design a system that ensures the former conclusion, focusing on improving patient care rather than increasing profits. It’s time for healthcare to embrace the power of Six Sigma and Lean Manufacturing methodologies to revolutionize patient outcomes.

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