Readmissions performance and penalty experience of safety-net hospitals under Medicare’s Hospital Readmissions Reduction Program

Autor: Souvik Banerjee, Michael K. Paasche-Orlow, Danny McCormick, Meng-Yun Lin, Amresh D. Hanchate
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: BMC Health Services Research, Vol 22, Iss 1, Pp 1-11 (2022)
Druh dokumentu: article
ISSN: 1472-6963
DOI: 10.1186/s12913-022-07741-9
Popis: Abstract Background The Hospital Readmissions Reduction Program (HRRP), established by the Centers for Medicare and Medicaid Services (CMS) in March 2010, introduced payment-reduction penalties on acute care hospitals with higher-than-expected readmission rates for acute myocardial infarction (AMI), heart failure, and pneumonia. There is concern that hospitals serving large numbers of low-income and uninsured patients (safety-net hospitals) are at greater risk of higher readmissions and penalties, often due to factors that are likely outside the hospital’s control. Using publicly reported data, we compared the readmissions performance and penalty experience among safety-net and non-safety-net hospitals. Methods We used nationwide hospital level data for 2009-2016 from the Centers for Medicare and Medicaid Services (CMS) Hospital Compare program, CMS Final Impact Rule, and the American Hospital Association Annual Survey. We identified as safety-net hospitals the top quartile of hospitals in terms of the proportion of patients receiving income-based public benefits. Using a quasi-experimental difference-in-differences approach based on the comparison of pre- vs. post-HRRP changes in (risk-adjusted) 30-day readmission rate in safety-net and non-safety-net hospitals, we estimated the change in readmissions rate associated with HRRP. We also compared the penalty frequency among safety-net and non-safety-net hospitals. Results Our study cohort included 1915 hospitals, of which 479 were safety-net hospitals. At baseline (2009), safety-net hospitals had a slightly higher readmission rate compared to non-safety net hospitals for all three conditions: AMI, 20.3% vs. 19.8% (p value
Databáze: Directory of Open Access Journals
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