Key result
The expansion of the Hospital Readmission Reduction Program to include COPD readmissions has substantial drawbacks and potential unintended consequences that could adversely affect providers and patients.
This perspective highlights the potential drawbacks and unintended consequences of penalizing hospitals for 30-day COPD readmissions under the CMS HRRP.
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Hospitals face new CMS penalties for COPD readmissions; leaves open effects on outcomes and care patterns.
In October 2014, the U.S. Centers for Medicare and Medicaid Services (CMS) will expand its Hospital Readmission Reduction Program (HRRP) to include chronic obstructive pulmonary disease (COPD). Under the new policy, hospitals with high risk-adjusted, 30-day all-cause unplanned readmission rates after an index hospitalization for a COPD exacerbation will be penalized with reduced reimbursement for the treatment of Medicare beneficiaries. In this perspective, we review the history of the HRRP, including the recent addition of COPD to the policy. We critically assess the use of 30-day all-cause COPD readmissions as an accountability measure, discussing potential benefits and then highlighting the substantial drawbacks and potential unintended consequences of the measure that could adversely affect providers, hospitals, and patients with COPD. We conclude by emphasizing the need to place the 30-day COPD readmission measure in the context of a reconceived model for postdischarge quality and review several frameworks that could help guide this process.
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Feemster et al. (2014) conducted a review in Chronic obstructive pulmonary disease (COPD). Hospital Readmission Reduction Program (HRRP) for COPD was evaluated on 30-day all-cause unplanned readmission rates. The expansion of the Hospital Readmission Reduction Program to include COPD readmissions has substantial drawbacks and potential unintended consequences that could adversely affect providers and patients.
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