title: Hospital Readmissions Reduction Program: Safety-Net Hospitals Show Improvement, Modifications To Penalty Formula Still Needed.
abstract: Many observers are calling for modification of Medicare's Hospital Readmissions Reduction Program (HRRP) to relieve an unfair burden on safety-net hospitals, which serve low-income populations and consequently have relatively high readmission rates. To broaden the perspective on this issue, we addressed the fundamental question of whether the HRRP has been an effective tool for reducing thirty-day readmissions in safety-net hospitals. In the first three years of the program, these hospitals reduced readmissions for heart attack by 2.86 percentage points, heart failure by 2.78 percentage points, and pneumonia by 1.77 percentage points, and they also reduced the disparity between their readmission rates and those of other hospitals. While the fairness issue remains unresolved, it appears that safety-net hospitals have been able to respond to HRRP incentives.
authors.affiliation: Kathleen Carey (kcarey@bu.edu) is a professor of health law, policy, and management in the School of Public Health at Boston University, in Massachusetts.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Carey
authors.affiliation: Meng-Yun Lin is a research data analyst in the Section of General Internal Medicine at Boston Medical Center, in Massachusetts.
authors.forename: Meng-Yun
authors.initials: MY
authors.lastname: Lin
mesh_terms: D006333:Heart Failure / Q000453:epidemiology; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D006278:Medicare / Q000191:economics; D009203:Myocardial Infarction / Q000453:epidemiology; D010359:Patient Readmission / Q000191:economics* / Q000706:statistics & numerical data*; D011014:Pneumonia / Q000453:epidemiology; D011203:Poverty; D058996:Quality Improvement; D064876:Safety-net Providers / Q000191:economics* / Q000706:statistics & numerical data; D014481:United States
keywords: Hospitals; Readmissons; Safety-Net