The Hospital Readmissions Reduction Program: Searching for a Better Measure

A hospital-wide readmission measure would increase penalties substantially for safety-net hospitals.

The Hospital Readmissions Reduction Program (HRRP; part of the Affordable Care Act) penalizes hospitals that have higher-than-expected 30-day readmissions for patients with five specific conditions (heart failure, myocardial infarction, pneumonia, hip or knee replacement, and chronic obstructive pulmonary disease). These current readmissions measures are not applicable to hospitals with smaller condition-specific volumes (fewer than 25 admissions during 3 years for each condition), and they disproportionately penalize large-volume safety-net hospitals. Would a hospital-wide readmission measure (reflecting all readmissions, not just readmissions for patients with the 5 specific conditions) be more effective and equitable?

Researchers used Med…

Reviewing Authors

Paul W. Helgerson, MD

Andrew S. Parsons, MD, MPH

Disclosures

Consultant/Advisory BoardNEJM Healer Advisory Group; Aquifer Clinical Excellence; NBME Clinical Reasoning

Grant/Research SupportSouthern Group on Educational Affairs (SGEA)

Editorial BoardsDiagnosis

Leadership Positions in Professional SocietiesUndergraduate Medical Education (UME) Section Chair, Southern Group on Educational Affairs (SGEA); Chair of Early Career Physicians, American College of Physicians (ACP), Virginia Chapter