Expanded readmissions penalties would hurt safety-net hospitals

Hospitals which serve more low-income patients could be penalized an additional $198,000 per year if the Hospital Readmissions Reduction Program (HRRP) is adjusted to include more conditions, according to a study published in The New England Journal of Medicine.

“Under the hospital-wide measure, all index stays contribute to a single, hospital-wide readmission rate, and hospitals have only one chance to be penalized, which concentrates the penalties while reducing the proportion of hospitals penalized,” wrote Rachael B. Zuckerman, PhD, and colleagues, all of whom are employed by HHS, which funded the study. “Since safety-net hospitals tend to perform slightly worse on the hospital-wide measure, they are more likely to receive a penalty, which would increase the disparity in penalties between the two groups.”

The authors said an existing issue with HRRP is the decreases in readmissions have been greater for the currently targeted conditions, such as heart failure and pneumonia, versus nontargeted conditions, suggesting there would be benefits to quality of care by including a wider range of conditions in the program.

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