Hospital Readmission Risk Varies Depending on Medicare Plan

A large review showed that Medicare Advantage patients had higher readmission rates than did patients with traditional Medicare for three common conditions.

The Hospital Readmissions Reduction Program (HRRP) penalizes hospitals with worse-than-expected 30-day readmission rates for patients covered by traditional Medicare as opposed to other sources of insurance coverage, such as Medicare Advantage (MA) plans. MA plans provide capitated payments, which should strongly incentivize lower care costs and fewer hospital readmissions; however, we do not have good data on risk-standardized readmission rates for nontraditional Medicare beneficiaries.

In this retrospective review of >4 million older patients (age, ≥65) who were admitted to >4700 U.S. acute care hospitals between 2011 and 2014, researchers found significantly higher risk-adjusted readmission rates for MA patients than for traditional Medic…

Reviewing Author

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

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

Hospital Readmission Risk Varies Depending on Medicare Plan

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Reviewing Author