Data-based insight on demand
As health plans and providers move more aggressively to contain costs and improve efficiency in their organizations, the issue of readmissions is facing more scrutiny than at any time in recent memory. It’s no secret why. According to some studies, unplanned readmissions cost approximately $13,000 per instance, adding up to an estimated $25 billion annually in the U.S. alone. Meanwhile, nearly 20% of inpatient admissions result in a readmission and the overwhelming majority of them –90%– are preventable.
If readmissions are largely preventable, why are they so persistent? Insufficient information is part of the answer. Leaders at health plans and providers can lack a clear understanding of exactly which controllable factors may be contributing to a preventable readmission event. In many cases, the problem isn’t that they lack data on these scenarios. What they seem to be missing is insight. That’s where Deloitte’s Readmissions Analyzer tool can help.
The Readmissions Analyzer helps healthcare leaders harness the power of their data to prevent readmissions and manage costs more effectively. At typical capacity, this approach has been demonstrated to provide more than 70% precision at more than 98% specificity.
This tool helps to give leaders an evidence-based model for predicting the likelihood of unplanned inpatient readmissions for individual members. The model uses inpatient, outpatient and pharmacy claims from Health Plan Data Factory (HPDF) data and applies advanced machine learning algorithms to generate readmission propensity scores.
The Readmissions Analyzer can introduce a host of benefits to help health providers struggling to keep readmissions under control, including:
- Improved ability to predict the likelihood of unplanned inpatient readmissions for individual members
- A clearer understanding of the reasons behind readmissions – and how to avoid them
- Adaptive capabilities for evolving in response to changing clinical conditions
- Periodically refreshed calibration tuned to organization-specific operating conditions
Looking for a smarter way to tackle the challenge of readmissions? We can help. Please reach out and let's get the conversation started.
Meet our people
- Casey T. Graves, Principal, Deloitte Consulting LLP