LexisNexis Assists Hospitals in Predicting Readmissions with Non-clinical Data

LexisNexis Risk Solutions announces the release of its new Socioeconomic Health Score – focused on assistance with predicting hospital readmission risk – at the Healthcare Information and Management Systems Society (HIMSS) Annual Conference and Exhibition, March 5-9 in Las Vegas.

The cutting-edge analytics model leverages hundreds of socioeconomic data attributes derived from public and proprietary records to help predict how likely a patient is to be readmitted to the hospital within 30 days. It can help hospitals improve risk stratification and redirect resources to focus on more effective discharge processes, aftercare counseling about medications or lifestyle choices, and other strategies to prevent medical complications or readmission – optimizing hospital reimbursements and minimizing penalties under current value-based performance programs.

“Healthcare regulations that penalize hospitals for readmission within 30 days of discharge are a major financial impact for care providers,” said Josh Schoeller, senior vice president, LexisNexis Risk Solutions. “In response, our access to and expertise on the application of non-healthcare data for improving outcomes enables us to help hospitals reduce these occurrences, minimize costs and allocate preventive resources more efficiently. This is a win for both hospitals and their patients.”

The Readmission Risk Score is part of a broader suite of socioeconomic solutions that utilize social determinants of health data (SDOH), which, according to the World Health Organization, is data on the “conditions in which people are born, grow, live, work and age” that impact their health. SDOH affect overall health outcomes more than medical determinants, according to County Health Rankings. Research conducted by LexisNexis indicated that the Readmission Risk Score is on par with—or better at predicting risk than—readmission scoring models that use only clinical data, which is often difficult to obtain.

To compete in today’s healthcare market, it is vital that providers improve risk stratification and adapt care management strategies to personalize care for its most at-risk patients. The Centers for Medicare & Medicaid Services (CMS) is making sure of that. Under the Hospital Readmissions Reduction Program (HRRP), CMS withholds up to 3 percent of Medicare reimbursements if hospitals have a higher-than-expected number of readmissions within 30 days of discharge for the following conditions:

  • Chronic lung disease;
  • Coronary artery bypass graft surgery;
  • Heart attacks;
  • Heart failure;
  • Hip and knee replacements; and
  • Pneumonia.

Of patients with these ailments, the LexisNexis risk score — which can be loaded into existing systems – helps to identify those at highest risk for readmission.

Also critical is that – under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) – there are quality measures related to readmissions that hospitals may choose to be measured against that would impact their financial reimbursements. Two key measurement areas are All-cause Hospital Readmission and Unplanned Hospital Readmission within 30 Days of Principal Procedure.

To learn more about the LexisNexis Socioeconomic Health Score: Readmission Risk Score and LexisNexis® Socioeconomic Health Attributes, visit booth #3438 at HIMSS18, or read our white paper, Six Myths About Social Determinants of Health.

Our health care solutions combine proprietary analytics, science and technology with the industry’s leading sources of provider, member, claims and public records information to improve cost savings, health outcomes, data quality, compliance and exposure to fraud, waste and abuse.

About LexisNexis Risk Solutions
At LexisNexis Risk Solutions, we believe in the power of data and advanced analytics for better risk management. With over 40 years of expertise, we are the trusted data analytics provider for organizations seeking actionable insights to manage risks and improve results while upholding the highest standards for security and privacy. Headquartered in metro Atlanta USA, LexisNexis Risk Solutions serves customers in more than 100 countries and is part of RELX Group, a global provider of information and analytics for professional and business customers across industries. For more information, please visit www.risk.lexisnexis.com.