Study: Readmission reduction program increases mortality in Medicare heart failure patients

The implementation of the Hospital Readmissions Reduction Program reduced the rate of readmissions, but also simultaneously increased the mortality rate of Medicare patients with heart failure, according to a study published in JAMA.

The team of researchers observed 115,245 fee-for-service Medicare patients hospitalized with heart failure at 416 hospitals across the U.S. between 2006 and 2014 to understand the impact of the program designed to reduce hospital readmissions. The observations were divided into time periods before and after HRRP penalties went into effect.

The ACA established the HRRP in 2010, which required hospitals to publicly disclose their 30-day readmission rates for heart failure, heart attack and pneumonia and created penalties for hospitals with high readmission rates.  

Here are five things to know.

1. The researchers found that 30-day readmission rates declined from 20 percent before to 18.4 percent after the implementation of the HRRP.

2. The 30-day risk-adjusted mortality rate increased from 7.2 percent before the program's implementation to 8.6 percent after the program was implemented.

3. The one-year risk-adjusted readmission rate declined from 57.2 percent prior to the program to 56.3 percent after.

4. The one-year risk adjusted mortality rate increased from 31.3 percent mortality before the HRRP implementation to 36.3 percent after the implementation.

5. The researchers concluded that among fee-for-service beneficiaries discharged after heart failure hospitalizations, the HRRP program was temporarily associated with reduction in admissions but an increase in mortality.

To read the full report click here.

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