Readmission

A readmission is a return to the hospital as an inpatient within 30 days of being discharged. It is one of the most watched quality numbers in American medicine, because a high readmission rate usually means something went wrong the first time: a discharge too early, a medication mix-up, an infection that was missed, or no one following up. Medicare publishes each hospital's rate for conditions like heart failure, pneumonia, heart attack, COPD, and hip and knee replacement.

The numbers are public and the spread is real. The national readmission rate after a hip or knee replacement is about 4 percent. The best surgery centers and orthopedic hospitals report 1 to 2 percent; some hospitals report 6 to 8 percent. Since 2012 Medicare has cut payments to hospitals with excess readmissions, up to 3 percent of their Medicare revenue, so hospitals take the number seriously. For a family, a readmission is a second deductible-and-coinsurance event in the same year on top of the misery. For a self-funded employer, a readmission after a $40,000 surgery is commonly another $15,000 to $25,000 claim that was avoidable. This is why TruePrice's quality scores lean on readmission and complication rates rather than on reputation or advertising.

The takeaway: before choosing a hospital for a planned surgery, look up its 30-day readmission rate for that procedure on Medicare's Care Compare site. A rate well below the national average is worth a longer drive.