- Hospitals that participate in voluntary value-based programs have fewer readmissions than those that rely on financial incentives alone to reduce high rates, a new study published online in JAMA Internal Medicine shows.
- University of Michigan researchers analyzed 30-day readmission rates for patients treated for heart attack, heart failure and pneumonia at 2,800 hospitals in 2005 through 2015 and found that hospitals that participated in Meaningful Use, accountable care organizations or bundled payments had greater reductions in readmissions.
- In 2015, all but 56 of the hospitals in the study were enrolled in at least one of the programs, versus none in 2010 when the Affordable Care Act was enacted.
For heart failure patients, participation in an ACO was associated with a 2.1% reduction in readmissions each year, while hospitals enrolled in meaningful use saw a 2.3% drop. Hospitals that participated in an ACO or meaningful use plus bundled payments had 2.6% and 2.5% fewer readmissions, respectively.
And hospitals that participated in all three programs saw even greater improvement: 2.9% for heart failure, 2% for heart attack and 1.9% for pneumonia.
“The impact of hospital participation ion these voluntary reforms is substantial,” the researchers write. “Combining our estimates with published figures on the number of readmissions and Medicare spending per readmission, we estimate that, across the 3 targeted diagnoses, in 2015 hospital participation in meaningful use, ACOs, and BPCI programs led to 2377 fewer readmissions … saving Medicare $32,746,283.”
Since implementation of the Medicare Hospital Readmissions Reduction Program (HRRP) 30-day readmission rates have fallen faster than at any time before 2012, particularly among the lowest-performing hospitals. According to CMS, federal efforts including HRRP have helped to prevent an estimated 565,000 Medicare patient readmissions since 2010.
A Kaiser Health News analysis published in August predicted that Medicare would withhold a record-breaking $528 million in readmission penalties on hospitals over the next year. To improve readmission rates, CMS last year called for proposals to develop Hospital Improvement and Innovation Networks, with the aim of reducing patient complications by 20% and 30-day readmissions by 12%.