CMS readmission penalties don't correlate with outcomes, are unfair to hospitals with sicker patients, study says

The CMS Hospital Readmissions Reduction Program may unfairly level 30-day readmission penalties against hospitals that care for more severely ill patient populations, according to a new study published in JAMA Cardiology.

For the study, researchers examined one-year heart attack outcomes for more than 50,000 patients treated at 377 hospitals. Researchers identified no difference in one-year mortality rates and long-term readmission rates between hospitals deemed to have high readmission rates per the 30-day standard.

"The current CMS readmission metric does not correlate with long-term clinical outcomes," said Ambarish Pandey, MD, a cardiologist with the University of Texas Southwestern Medical Center in Dallas and one of the study's authors.

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Analysis also revealed the hospitals most often penalized for 30-day heart attack readmissions were those serving larger ethnic minority patient populations and patients afflicted with more severe illnesses.

"Our findings raise concern about the fair and equitable allocation of CMS penalties for readmissions," said James de Lemos, MD, PhD, associate director of the cardiovascular fellowship program at UT Southwestern Medical Center in Dallas and the senior author of the study. "It is fundamentally unfair to penalize hospitals for factors that are beyond their control. We support proposed changes to pay for performance that would consider socioeconomic status in the risk-adjustment methods to calculate rewards and penalties."

The new study adds to a growing body of research that suggests the CMS readmission reduction program is unfair.

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