Hospital readmission improvements under Medicare program overstated, study finds

Success from the Hospital Readmissions Reduction Program, which penalizes hospitals with high 30-day readmission rates among Medicare beneficiaries, may be overstated, according to a study published in Health Affairs.

Five findings from the study:

1. While prior studies have credited the HRRP with lowering risk-adjusted readmission rates for conditions like acute myocardial infarction, heart failure and pneumonia, a concurrent change in how hospitals document diagnoses may have caused those results to be "illusory or overstated," according to the study.

2. The change, which affected the electronic transaction standards, allowed hospitals to include more diagnoses per claim. As a result, risk-adjusted patient readmission rates fell, according to the study.

3. Previous studies concerning HRRP were based on control groups with lower baseline readmission rates, which the authors said "could falsely create the appearance that readmission rates are changing more in the treatment than in the control group."

4. When the researchers included the revised standards, they saw the decline in risk-adjusted readmission rates for targeted conditions was reduced by 48 percent.

5. "After further adjusting for differences in pre-HRRP readmission rates across samples, we found that declines for targeted conditions at general acute care hospitals were statistically indistinguishable from declines in two control samples," the authors wrote. "Either the HRRP had no effect on readmissions, or it led to a systemwide reduction in readmissions that was roughly half as large as prior estimates have suggested."

To view the full report, click here.

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