Dive Brief:

• Although the Hospital Readmissions Reduction Program is designed to provide incentives for hospitals to reduce unnecessary hospital readmissions, hospitals in San Diego County are being penalized due to a problem with the way Medicare measures progress, a new analysis says. 
• The problem, according to the analysis from Altarum Institute, "is that Medicare measures progress by dividing the number of readmissions by the number of discharges from each hospital." However, "it turns out that good practices reduce the discharges at nearly the same rate as readmissions, making the ratio stay the same despite substantial improvement." 
• "Some hospitals and communities are creating the standard for best practices, and the rest of the country should be learning from them," said the Institute's director Joanne Lynn, in a statement. "Instead, the measure that Medicare uses makes them appear to make little progress and most of their hospitals are being penalized. Medicare is knowingly using a measure that does not reliably indicate progress or failure."

Dive Insight:

That hospitals can't get kudos after reducing readmissions is pretty disheartening news, and certainly makes for attention-grabbing headlines. Perhaps CMS needs to re-evaulate its math process as it finesses the readmissions reduction program. 

In an accompanying blog, Stephen Jencks, who co-authored the initial report on the high rate of readmissions in Medicare patients, contends that the Medicare program should quickly take steps to restore basic fairness in the hospital penalty program and should develop the metrics that the healthcare system needs to guide improvements.

Another issue with the CMS program is that hospitals serving patients in lower socioeconomic classes often have the highest rate of readmissions, and there is little to do to prevent them, an AHA spokesman recently told Healthcare Dive. Recent data from CMS show that approximately 77% of hospitals serving the poorest patients incur a readmissions penalty. By contrast, only 36% of hospitals with the fewest poor patients will receive a penalty.