Safety-net hospitals see decline in readmissions despite policy challenges

From 2013 to 2016, combined 30-day readmissions for heart attack, heart failure and pneumonia patients saw sharper declines in safety-net hospitals than other hospitals, according to a recent study published in Health Affairs.

The authors of the study used data from Medicare's Hospital Compare website to analyze readmission rates for safety-net hospitals and other hospitals for the fiscal years 2013 and 2016. Researchers found overall readmissions rates declined more at safety-net hospitals than other hospitals. Heart attack readmissions saw a 2.64 percent decline at other hospitals and a 2.86 percent decrease at safety-net hospitals, causing the study's authors to note that there was more room for improvement among the safety-net hospitals.

In 2013, the ACA's Hospital Readmissions Reduction Program granted CMS the ability to penalize hospitals for 30-day readmissions exceeding national readmission averages. The move drew criticism from safety-net supporters because these facilities care for the nation's most vulnerable populations, which are more likely to be readmitted 30-days after hospitalization.

"In refining the HRRP, policy makers should bear in mind that a penalty program may not provide the best lever for incentivizing performance improvement in safety-net hospitals," concluded the authors. "It would be advisable for CMS to pay attention to characteristics of hospitals that succeed in reducing readmissions as it modifies and expands the HRRP."

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