Issues Surround Hospital Readmissions Reduction Program

Issues include methodology for determining expected readmission rates, computing penalties

FRIDAY, Dec. 6, 2013 (HealthDay News) -- Concerns surround implementation of the Medicare Hospital Readmissions Reduction Program (HRRP), according to a policy brief published online Nov. 12 in Health Affairs.

Julia James, a health policy consultant, discusses issues and concerns relating to implementation of the HRRP, established as a provision of the Affordable Care Act, which imposes a financial penalty on hospitals with excess Medicare readmissions.

James notes that historically about one in five Medicare patients were readmitted within 30-days of discharge, with considerable variation by hospital and geographic area. Although strategies have been employed to prevent readmissions, the results have been mixed. Concern has been expressed about the HRRP, including whether hospitals are being treated fairly and whether hospitals should be held accountable for things that are out of their control, such as patient behavior and post-acute care provider performance. In addition, HRRP does not account for socioeconomic status of the patient population, a factor that can affect readmission rates. Other problematic issues include methodology for determining readmission rates and computing penalties. Furthermore, employing effective readmission reduction strategies is expensive and unaffordable for some hospitals, and consequently hospitals may be unable to avoid the penalties.

"One consequence of the Medicare HRRP may be a growing recognition that reducing readmissions is a shared responsibility that belongs not only to hospitals but also to patients and their caregivers and to other community professionals and providers across the continuum of health and social services," the author writes.

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