From GWU: Reducing Hospital Readmissions Among Medicaid Patients: A Review of the Literature

Qual Manag Health Care. 2014 October/December;23(4):203-225.

Reducing Hospital Readmissions Among Medicaid Patients: A Review of the Literature.

Regenstein M1, Andres E.

Author information

• 1Department of Health Policy, George Washington University School of Public Health and Health Services, Washington, District of Columbia (Drs Regenstein and Andres).

Abstract

Reducing hospital readmissions is a key approach to curbing health care costs and improving quality and patient experience in the United States. Despite the proliferation of strategies and tools to reduce readmissions in the general population and among Medicare beneficiaries, few resources exist to inform initiatives to reduce readmissions among Medicaid beneficiaries. Patients covered by Medicaid also experience readmissions and are likely to experience distinct challenges related to socioeconomic status. This review aims to identify factors related to readmissions that are unique to Medicaid populations to inform efforts to reduce Medicaid readmissions. Our search yielded 254 unique results, of which 37 satisfied all review criteria. Much of the Medicaid readmissions literature focuses on patients with mental health or substance abuse issues, who are often high utilizers of health care within the Medicaid population. Risk factors such as medication noncompliance, postdischarge care environments, and substance abuse comorbidities increase the risk of readmission among Medicaid patients.