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September 18, 2019Medical CareOpen Access

Relative Effects of the Hospital Readmissions Reduction Program on Hospitals That Serve Poorer Patients

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Key result

Among the highest-penalized hospitals, the pre-post HRRP decline in readmission rates was significantly less for hospitals serving a high versus low proportion of dual-eligible patients (P<0.0001).

Why the study?

Does the Hospital Readmissions Reduction Program reduce readmission rates differently in hospitals serving high versus low proportions of dual-eligible patients?

Population

Medicare fee-for-service beneficiaries aged 65 years or older discharged alive from January 1, 2003 to…

Comparison

Hospital Readmissions Reduction Program passage vs Pre-law period and comparison between hospitals…

Design

Cohort

Follow-up

January 1, 2003 to November 30, 2014

Authors

JWJason H. WasfyMassachusetts General HospitalVBVijeta BhambhaniVerastem (United States)EHEmma HealyNovartis (Switzerland)

Discussion

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Member takes

Overview

High dual-eligible penalized hospitals showed smaller readmission improvements; leaves open whether HRRP exacerbates disparities in safety-net care.

Study Design

Type

Cohort

Multicenter

Yes

Structured PICO

Does the Hospital Readmissions Reduction Program reduce readmission rates differently in hospitals serving high versus low proportions of dual-eligible patients?

P
Population
Medicare fee-for-service beneficiaries aged ≥65 years discharged alive with AMI, CHF, or pneumonia from US acute care hospitals between 2003 and 2014.
E
Exposure
Hospital Readmissions Reduction Program (HRRP) passage (2010)
C
Comparator
Pre-law period (before 2010) and comparison between hospitals with high versus low proportions of dual-eligible patients
O
Outcome
Decrease in hospital-level risk-standardized readmission rates (RSRRs) in the post-law period, after controlling for the pre-law trend

The Hospital Readmissions Reduction Program may disproportionately disadvantage hospitals serving poorer populations, as highly penalized hospitals with high proportions of dual-eligible patients showed less improvement in readmission rates.

Cite This Study

Wasfy et al. (2019) conducted a cohort in Acute myocardial infarction, congestive heart failure, and pneumonia. High proportion of dual-eligible patients vs. Low proportion of dual-eligible patients was evaluated on Decrease in hospital-level risk-standardized readmission rates (RSRRs) in the post-law period. Among the highest-penalized hospitals, the pre-post HRRP decline in readmission rates was significantly less for hospitals serving a high versus low proportion of dual-eligible patients (P<0.0001).

synapsesocial.com/papers/6ab35e33f522bae22b32aff6https://doi.org/10.1097/mlr.0000000000001207
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Readmission Rates After Passage of the Hospital Readmissions Reduction Program2016 · 165 citations
  2. 2The Medicare Hospital Readmissions Reduction Program: Potential Unintended Consequences for Hospitals Serving Vulnerable Populations2014 · 134 citations
  3. 3Association Between Hospital Penalty Status Under the Hospital Readmission Reduction Program and Readmission Rates for Target and Nontarget Conditions2016 · 275 citations
  4. 4Reducing excess readmissions: promising effect of hospital readmissions reduction program in US hospitals2015 · 58 citations
  5. 5The Analysis of Hospital Readmission Rates After the Implementation of Hospital Readmissions Reduction Program2021 · 3 citations