Hospital readmissions reduction program penalizes safety net hospital clinicians.
| Autor: | Kirsch S; Sarah Kirsch practices in critical care at Northwell Health, North Shore University Hospital, in Manhasset, N.Y. Yousra Elsir practices in urology oncology surgery at Stanford Health Care in Palo Alto, Calif. Katie Shelford practices in bariatric surgery at Community Health Network in Indianapolis, Ind. Janessa Vail practices in critical care at Saint Francis Hospital & Heart Center in Roslyn, N.Y. Anne Wildermuth is an assistant professor in the School of Medicine at the Uniformed Services University of the Health Sciences in Bethesda, Md., and practices in emergency medicine at MedStar Emergency Physicians in Clinton, Md. The authors have disclosed no potential conflicts of interest, financial or otherwise., Elsir Y, Shelford K, Vail J, Wildermuth A |
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| Jazyk: | angličtina |
| Zdroj: | JAAPA : official journal of the American Academy of Physician Assistants [JAAPA] 2024 Dec 01; Vol. 37 (12), pp. 44-47. Date of Electronic Publication: 2024 Dec 21. |
| DOI: | 10.1097/01.JAA.0000000000000161 |
| Abstrakt: | Objective: The Hospital Readmissions Reduction Program (HRRP), started under the Patient Protection and Affordable Care Act and administered by the Centers for Medicare and Medicaid Services, was created with the intention to improve healthcare quality and costs. However, research on disparities in healthcare demonstrates the HRRP's protocolized risk-adjustment calculations neglect social factors, which consequently harms disadvantaged patient populations and unfairly contributes to clinician and hospital penalties. Methods: A PRISMA literature review was conducted using PubMed and Cochrane Library to explore the inclusion of social factors such as socioeconomic status on risk-adjustment calculations, and their relation to healthcare disparities, penalties, and outcomes. Fifteen articles published in the past 10 years were reviewed. Results: Eleven (73%) of the 15 articles in this systematic review indicated that the HRRP potentiated healthcare disparities based on risk-adjustment calculation. Conclusions: This review strongly suggests modifying the HRRP risk-adjustment calculations to include social risk factors has the potential to equalize reimbursement for hospitals that serve the most vulnerable patients and reduce negative unintended consequences of the HRRP. Future studies are needed to produce more conclusive, consistent evidence on the effect of social risk factors in risk-adjustment calculations and associated outcomes and to determine how HRRP's risk-adjustment calculations can be modified to reduce disparities in healthcare. (Copyright © 2024 American Academy of Physician Associates.) |
| Databáze: | MEDLINE |
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