Numerator
Count of acute hospitalizations followed by an acute hospital readmission within 30 days among Medicare FFS beneficiaries
Methodology
All Inpatient1 (IP1) claims for a year 1/1/yyyy thru 12/31/yyyy were considered as potential index claims and readmission claims. IP1 claims were acute or critical access hospitalization claims. Index claims were limited to IP1 admissions where the discharge status is not “died in hospital”. If for a beneficiary (index claim discharge date > next claim admit date) or (index claim discharge date = next claim admit date and discharge status is “still a patient”) then the two claims merged into a single stay. The readmission time frame extends into the first 30 days of the following year.
Medicare FFS beneficaries limited to those who (a) have no months of HMO enrollment and (b) have both Part A and Part B for whatever portion of the year that they are covered by FFS Medicare (i.e., they have no months of A-only or B-only coverage).
Beneficiary age group (< 65 and 65+ ) was determined using the age of the individual at the end of the reference year or the individual's age at the time of death.