The first endorsed measure, developed by the National Committee for Quality Assurance, counts the number of inpatient stays for patients aged 18 and older during a measurement year that were followed by an acute readmission for any diagnosis to any hospital within 30 days. It contrasts this count with a calculation of the predicted probability of an acute readmission. NCQA’s measure is intended for quality monitoring and accountability at the health plan level.
The second measure, co-developed by CMS and researchers at Yale University, estimates the risk-standardized rate of unplanned, all-cause readmissions to a hospital for any eligible condition within 30 days of hospital discharge for patients aged 18 and older. The measure will result in a single summary risk-adjusted readmission rate for conditions or procedures that fall under five specialties: surgery/gynecology, general medicine, cardiorespiratory, cardiovascular and neurology. The CMS/Yale measure is specified for evaluating hospital performance.
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