A study from the University of Colorado School of Medicine, published in the Journal of Post-Acute and Long-Term Care Medicine, found that nearly 23 percent of patients discharged to post-acute care facilities (“PAC”) following acute hospitalization were readmitted at least once within 30 days. Nearly half of the readmissions occurred within two weeks of discharge. Further, the study noted that patients readmitted to acute care were twice as likely to die within 30 days of hospital discharge and nearly four times as likely to die within 100 days of discharge.

The increase in discharges to PAC facilities appears to be a result of various incentives implemented by the Federal government. For example, the Patient Protection and Affordable Care Act of 2010 contains multiple payment reforms intended to promote hospital efforts to address and prevent readmission after discharge. The most significant being a financial penalty for hospitals with above-average readmission rates certain illnesses. Since those penalties were implemented in 2012, more than 2200 hospitals had up to 2% of their annual Medicare reimbursements withheld due to excess readmissions.

Thus, the University of Colorado study notes that “hospitals are incentivized to discharge these patients as early as possible, and in contrast to discharges home, hospitals are not currently penalized for readmissions from a PAC facilities.” Thus, “PAC facilities may be substituting for prolonged hospital care in some cases.”

In essence, Hospitals that quickly discharge patients to PAC facilities have found a way to discharge patients quickly, while at the same time avoiding any risk that its Medicare reimbursement will be reduced should those same patients be readmitted to the Hospital. This renders the incentives meaningless, because the original intent of these incentives—providing better patient care—is being ignored by Hospitals that appear to be more interested in gaming the system to improving revenue.

A link to the study abstract can be found here:

[Hospital Readmission From Post-Acute Care Facilities: Risk Factors, Timing, and Outcomes](http://www.jamda.com/article/S1525-8610(15)00705-7/abstract?cc=y=)