Lessons Learned from the Hospital Readmission Reduction Program

Joseph F Buell, Geoffrey Parker, Paul Friedlander and Michael Darden

Department of Surgery, Tulane Transplant Institute, School of Medicine, Tulane University, New Orleans, USA
Department of Surgery, Thayer School of Engineering, Dartmouth College, Hanover, New Hampshire, USA
Department of Surgery, Milken Institute School of Public Health, George Washington University, Washington DC,USA

^*Correspondance to: Joseph F Buell 

 PDF  Full Text DOI: 10.25107/2474-1647.1911

Abstract

The Affordable Care Act implemented the Hospital Readmissions Reduction Program (HRRP) as a cost containment measure within the Social Security Act.
Methods: Examine racial parity in the HRRP, utilizing a cross-sectional analysis of Center for Medicare and Medicaid Services (CMS) and American Community Survey (ACS) data for 2015 CMS reimbursement. Analyze population share and hospital performance including risk-adjusted excess readmissions, overall patient experience, surgical mortality, and readmissions.
Results: Reimbursement cuts were greatest in hospitals serving African-Americans (p<0.001) and lower median income (p<0.001). Significant risk adjusted readmission disparities exist for African- Americans in all current measured parameters (p<0.001) and remain after adjusting for income and insurance as well as being magnified across national hospital rankings.
Conclusion: Our data provides direct evidence that HRRP inequitably reduces reimbursement among hospitals that serve a larger fraction of African-American, lower socioeconomic share individuals and safety net hospitals.

Keywords

Readmission; HRRP; Reduction Program; Affordable Care Act; Safety Net

Cite the article

Buell JF, Parker G, Friedlander P, Darden M. Lessons Learned from the Hospital Readmission Reduction Program. Clin Surg. 2018; 3: 1911.