Readmission Reduction Program
  • Readmission Reduction Program
  • Readmission Reduction Dashboard
  • Readmission Reduction Trend

Readmission Reduction Program

OneView allows organizations reduce readmissions and ED utilization by reporting metrics and dashboards. Reporting readmission performance by data range, attending provider, location, unit, hospital, ICD-9, etc. OneView can help quickly create a single source of truth for this important outcomes metric within your organization.

Below are links to the CMS Readmissions Reduction Program and/or local state programs including Community Hospital Acceleration, Revitalization, & Transformation (CHART), the Massachusetts grant program.

Download a Readmission Reduction Report from the Data Repository Network.





Hospitals in Massachusetts are participating in grant programs to help defer the cost to reduce remissions and ED utilization. The program is called the CHART grant through the Health Policy commission. There are inpatient readmission projects for the individual hospitals but there is also a Joint Grant for hospital systems.

Current solutions run through billing for ED and different systems for inpatient readmissions. This process is cumbersome and does not include many measures that are reportable because of the tracking limitations. OneView utilizes a datamart that is efficient, includes all CMS (or state) metrics, and can be used for an individual hospital or hospital system. Example of what we could track (but not limited to):

Dashboards and Detailed Reporting:

  • Percentage of cohort who returned within 30 days
  • Presence of MOLST form
  • Age groups of patients in program
  • Active vs inactive (deceased) patients in program
  • Number of medications patients are taking
  • Payer distribution
  • Length of inpatient stay
  • Discharge dispositions
  • Readmission Statistics
  • Percentage of Patients Medication Orders Reviewed during Admission
  • Percentage of Patients Medication Orders Reviewed during Discharge
  • Touch point tracking per patient 

Additional reporting:

  • Number of home visits conducted
  • Risk assessment scoring
  • Number of times patients referred to a specialist
  • Percentage of patients overlapping ACO, PACE, etc
  • Adherence to appointments with our patient cohort
  • Percentage of motivational interviews
  • Percentage of patients referred to palliative care
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