Study: CMS hospital readmission penalties made an impact

Dive Brief:

  • Since the passage of the Medicare Hospital Readmissions Reduction Program (HRRP), 30-days readmission rates for myocardial infarction, heart failure and pneumonia "decreased more rapidly than before the law's passage," according to a recent study published in Annals of Internal Medicine.
  • In 2012, CMS under HRRP began reducing Medicare payments for inpatient prospective payments for eligible hospitals with excessive readmissions. 
  • “Our main findings suggest that passage of the law was followed by widespread reductions in readmission rates, even with control for pre-law trends, and that this effect was most concentrated among the lowest-performing hospitals,” the study's authors were quoted in Modern Healthcare.

Dive Insight:

"Improvement was most marked for hospitals with the lowest pre-law performance," the authors noted.

More than half of all U.S. hospitals (2,497) will be punished based on their rehospitalization rates in fiscal year 2017 for patients who were discharged from July 2012 through June 2015, Kaiser Health News estimated in August

The authors noted their study is limited by the inability to distinguish improvements caused by "magnitude of the penalty" or varying health improvements spread across different patient populations.

Still, the new study echoes data shared by CMS in September where the District of Columbia and 49 states reduced avoidable hospital readmission rates between 2010 and 2015. The agency said at the time federal efforts to address readmission rates like the ACA's HRRP are working as Medicare patients avoided an estimated 565,000 readmissions since 2010. 

However, the HRRP penalties highlight a shared concern among hospitals that have more low-income patients than others as these patients "can have more trouble recuperating, sometimes because they can’t afford their medications or lack social support to follow physician instructions, such as reducing the amount of salt that heart failure patients consume," as noted by KHN. 

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Filed Under: Hospital Administration
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