Reducing Readmissions Through HEDIS-Aligned Digital Recovery Support
Why This Matters Now
Substance use disorder readmissions are among the most costly and most preventable challenges facing health plans today. With Plan All-Cause Readmissions (PCR) weighted 3x in CMS Star Ratings — and Follow-Up After ED Visit (FUA) and Follow-Up After High-Intensity Care (FUI) both tracking care continuity in the days after discharge — the financial and quality stakes have never been higher.
The Gap Between Crisis and Care
The 7–30 day period following discharge is when SUD members are most vulnerable. Without immediate, accessible support, they cycle back through emergency departments and inpatient stays—driving up costs and dragging down quality scores.
Integrated digital recovery support gives health plans a way to close the 7–30 day gap at scale — supporting FUA/FUI follow-up compliance and protecting Star Ratings performance while managing medical costs.
Bottom Line:
Reducing SUD readmissions requires meeting members where they are, when they need support most, and doing so in a way that aligns with the HEDIS measures health plans are already accountable for.
