Study: Safety-Net Hospitals Hurt Most by Readmission Penalties

Large hospitals, teaching hospitals and safety-net hospitals are more likely to be highly penalized under the Hospital Readmissions Reduction Program than small hospitals, nonteaching hospitals and non-safety-net hospitals, respectively, according to a research letter published in the Journal of the American Medical Association.

Researchers studied the likelihood of different types of hospitals to receive Medicare payment cuts for having higher-than-predicted readmission rates under CMS' Hospital Readmissions Reduction Program. CMS announced the hospitals that will receive penalties for fiscal year 2013 in August.

Researchers categorized the top half of these hospitals as having high penalties, the bottom half of hospitals as having low penalties and other hospitals in the HRRP Supplemental Data File as having no penalties.

The authors used the 2011 American Hospital Association annual survey to identify large hospitals — those with 400 beds or more; small hospitals — those with fewer than 200 beds; major teaching hospitals — those with membership in the Council of Teaching Hospitals; and safety-net hospitals — those in the highest quartile of the disproportionate share hospital index.

Data showed that of 3,282 hospitals, 2,189 (66.7 percent) will receive payment cuts.

The authors found that the odds of being highly penalized are greatest for safety-net hospitals. Here are some other key findings from the study:

•    Forty percent of large hospitals will be highly penalized, compared with only 28 percent of small hospitals.

•    Twenty-four percent of large hospitals will receive no payment cuts, compared with 47 percent of small hospitals.

•    Forty-four percent of major teaching hospitals will be highly penalized, compared with 33 percent of nonteaching hospitals.

•    Nineteen percent of major teaching hospitals will receive no penalties, while 35 percent of nonteaching hospitals will not receive any payment cuts.

•    Forty-four percent of safety-net hospitals will receive high penalties, while only 30 percent of non-safety-net hospitals will be highly penalized.

More Articles on Hospital Readmissions:

Study: Medicare Readmissions Decreased More in Areas With Quality Improvement Initiatives
"Post-Hospital Syndrome" May Play Role in Readmissions

Improving HCAHPS Scores Alone is Not the Answer: Hospitals Need a Patient-Centric Foundation

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