title: Higher readmissions at safety-net hospitals and potential policy solutions.
abstract: The Hospital Readmissions Reduction Program (HRRP), established by the Affordable Care Act, ties a hospital's payments to its readmission rates--with penalties for hospitals that exceed a national benchmark--to encourage hospitals to reduce avoidable readmissions. This new Commonwealth Fund analysis uses publicly reported 30-day hos­pital readmission rate data to examine whether safety-net hospitals are more likely to have higher readmission rates, compared with other hospitals. Results of this analysis find that safety-net hospitals are 30 percent more likely to have 30-day hospital readmission rates above the national average, compared with non-safety-net hospitals, and will therefore be disproportionately impacted by the HRRP. Policy solutions to help safety-net hospi­tals reduce their readmission rates include targeting quality improvement initiatives for safety-net hospitals; ensuring that broader delivery system improvements include safety-net hospitals and care delivery systems; and enhancing bundled payment rates to account for socioeconomic risk factors.
authors.affiliation: The Commonwealth Fund, USA. jb@cmwf.org
authors.forename: Julia
authors.initials: J
authors.lastname: Berenson
authors.forename: Anthony
authors.initials: A
authors.lastname: Shih
mesh_terms: D060866:Accountable Care Organizations; D014487:Centers for Medicare and Medicaid Services, U.S.; D006291:Health Policy; D006333:Heart Failure; D006761:Hospitals; D006801:Humans; D008484:Medicaid; D006278:Medicare; D009203:Myocardial Infarction; D058991:Patient Protection and Affordable Care Act; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011014:Pneumonia; D011785:Quality Assurance, Health Care; D058996:Quality Improvement; D012051:Reimbursement Mechanisms; D020444:Reimbursement, Disproportionate Share / Q000706:statistics & numerical data*; D012307:Risk Factors; D012959:Socioeconomic Factors; D017664:Uncompensated Care; D014481:United States; D035862:Vulnerable Populations