The Effect of the Hospital Readmission Reduction Program on the Duration of Observation Stays: Using Regression Discontinuity to Estimate Causal Effects

Medicare patients residing within High Value Healthcare Collaborative regions with index admissions for heart failure from January 1, 2012 to June 30, 2015 and a subsequent observation stay within 60 days. Excluded hospitals with <25 HF readmissions/year or <5 observation stays/year, and patients with subsequent observation stays at a different hospital.

Hospital Readmission Reduction Program (HRRP) 30-day cutoff for readmission penalties

Observation stays occurring after the 30-day cutoff (non-penalized) versus before the cutoff (penalized)

Duration of observation stays, percent of observation stays over 12 hours, and percent of observation stays over 24 hours