Nav: Home

Readmission penalties for safety net hospitals drop under new rules

April 29, 2019

DALLAS - April 29, 2019 - Readmission penalties against hospitals providing care to socioeconomically disadvantaged patients have dropped 14 percentage points under new rules adopted in 2019 that more equitably account for low-income populations being served, according to a new analysis led by UT Southwestern Medical Center and Harvard researchers.

Hospitals serving low-income populations have traditionally been disproportionately penalized for hospital readmissions under the Hospital Readmissions Reduction Program designed to reduce health system costs, explained Dr. Ambarish Pandey, Assistant Professor of Internal Medicine at UT Southwestern and senior author. The new rules adopted in 2019 instead compare similar hospitals, such as groups of large safety net hospitals.

The stratified payment method had the most significant impact among the hospitals serving socioeconomically disadvantaged populations, reducing penalties by 14 percentage points. Across all hospitals, the savings were about 4 percentage points," said Dr. Pandey, a Texas Health Resources Clinical Scholar. "The more equitable distribution of penalties among these hospitals lessens the burden carried by hospitals caring for patients of low socioeconomic status."

The investigation of more than 3,000 hospitals is one of the first to examine the effectiveness of the new rules to help level the playing field by comparing penalties for all hospitals to the reclassified hospitals that serve low socioeconomic status populations for four targeted medical conditions:
    Acute myocardial infarction (heart attack)

    Heart failure

    Chronic obstructive pulmonary disease

    Pneumonia.
"The results also show the greatest reductions in readmissions came in heart-related conditions," said Dr. Pandey, a cardiologist whose clinical expertise focuses on prevention of cardiovascular disease.

Researchers found the Hospital Readmission Reduction Program:
    Reduced penalties from 79 percent to 75 percent across all hospitals (a 4 percentage point reduction).

    Reduced penalties from 91 percent to 77 percent across safety net hospitals (a 14 percentage point reduction)

    Had the greatest impact on nonteaching, physician-owned hospitals in rural regions
The research appears in JAMA Open Network. This research was performed in collaboration with investigators from different U.S. institutions including Brigham and Women's Hospital, Massachusetts General Hospital, Northwestern University, and UCLA Health.

"Our study findings highlight the benefits of an effective policy modification by the Centers for Medicare and Medicaid Services (CMS)," said Dr. Cian P. McCarthy, lead author from Massachusetts General Hospital.

"Dual-eligible patients, those eligible for both Medicare and Medicaid, represent a complex, high-risk cohort that account for a third of spending in both programs," said Dr. Muthiah Vaduganathan, co-first author from Brigham and Women's Hospital. "The new stratified peer group-based assessment of hospital performance is a welcome initial step and addresses variation in care provided to dual-eligible patients across hospital systems in the U.S."
-end-
About UT Southwestern Medical Center

UT Southwestern, one of the premier academic medical centers in the nation, integrates pioneering biomedical research with exceptional clinical care and education. The institution's faculty has received six Nobel Prizes, and includes 22 members of the National Academy of Sciences, 17 members of the National Academy of Medicine, and 15 Howard Hughes Medical Institute Investigators. The full-time faculty of more than 2,500 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide care in about 80 specialties to more than 105,000 hospitalized patients, nearly 370,000 emergency room cases, and oversee approximately 3 million outpatient visits a year.

UT Southwestern Medical Center

Related Hospital Readmissions Articles:

Providing follow-up care after heart attack helps reduce readmissions, deaths
A program designed to help heart attack patients with the transition from hospital to outpatient care can reduce readmissions and deaths and increase the number of patients keeping follow-up appointments, a new study suggests.
Short-term hospital readmissions for gun injuries cost $86 million a year
Hospital readmissions of patients within six months of suffering a firearm injury cost taxpayers, private insurers and uninsured families an average of $86 million a year from 2010 through 2015, according to new estimates from Stanford University School of Medicine researchers.
Is program to reduce hospital readmissions associated with a change in patient deaths?
The Hospital Readmissions Reduction Program (HRRP) was created under the Affordable Care Act and hospitals face financial penalties for higher-than-expected 30-day readmission rates for patients with heart failure, heart attack and pneumonia.
Readmissions reduction program may be associated with increase in patient-level mortality
A policy designed to reduce hospital readmissions through financial penalties was associated with a significant increase in post-discharge mortality for patients with heart failure and pneumonia, according to a large-scale study by researchers in Beth Israel Deaconess Medical Center's (BIDMC) Smith Center for Outcomes Research in Cardiology.
UC researchers find chronic rhinitis influences hospital readmissions for asthma and COPD patients
Patients hospitalized for either asthma or chronic obstructive pulmonary disease (COPD) have a higher risk of being readmitted for a hospital stay within 30 days of release if they also suffer from chronic rhinitis, according to a trio of researchers at the University of Cincinnati.
More Hospital Readmissions News and Hospital Readmissions Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Erasing The Stigma
Many of us either cope with mental illness or know someone who does. But we still have a hard time talking about it. This hour, TED speakers explore ways to push past — and even erase — the stigma. Guests include musician and comedian Jordan Raskopoulos, neuroscientist and psychiatrist Thomas Insel, psychiatrist Dixon Chibanda, anxiety and depression researcher Olivia Remes, and entrepreneur Sangu Delle.
Now Playing: Science for the People

#537 Science Journalism, Hold the Hype
Everyone's seen a piece of science getting over-exaggerated in the media. Most people would be quick to blame journalists and big media for getting in wrong. In many cases, you'd be right. But there's other sources of hype in science journalism. and one of them can be found in the humble, and little-known press release. We're talking with Chris Chambers about doing science about science journalism, and where the hype creeps in. Related links: The association between exaggeration in health related science news and academic press releases: retrospective observational study Claims of causality in health news: a randomised trial This...