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Penalties Under ACA Tied to Drop in Medicare Readmission Rates


HealthDay News
Updated: Dec 28th 2016

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WEDNESDAY, Dec. 28, 2016 (HealthDay News) -- Passage of the Medicare Hospital Readmissions Reduction Program (HRRP) under the Affordable Care Act is associated with a more rapid decrease in 30-day risk-standardized readmission rates (RSRRs), according to a study published online Dec. 27 in the Annals of Internal Medicine.

Jason H. Wasfy, M.D., M.Phil., from Massachusetts General Hospital in Boston, and colleagues examined whether passage of the HRRP correlated with acceleration in improvement in 30-day RSRRs after hospitalization for acute myocardial infarction, congestive heart failure, or pneumonia. Data were included for 15,170,008 Medicare patients discharged alive from 2000 to 2013. Thirty-day readmission rates were assessed after hospitalization at hospitals stratified by hospital performance: highest performance (0 percent penalty), average performance (>0 percent and <0.50 percent penalty), low performance (≥0.5 percent and <0.99 percent penalty), and lowest performance (≥0.99 percent penalty).

The researchers found that, of the 2,868 hospitals serving 1,109,530 Medicare discharges annually, 30.1, 44.0, 16.8, and 9.0 percent were highest, average, low, and lowest performers, respectively. After passage of the law, an additional 67.6, 74.8, 85.4, and 95.1 readmissions per 10,000 discharges were averted per year in the highest-, average-, low-, and lowest-performance groups, respectively, after controlling for prelaw trends.

"After passage of the HRRP, 30-day RSRRs for myocardial infarction, heart failure, and pneumonia decreased more rapidly than before the law's passage," the authors write.

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