Higher readmissions at safety-net hospitals and potential policy solutions

Issue Brief (Commonw Fund). 2012 Dec:34:1-16.

Abstract

The Hospital Readmissions Reduction Program (HRRP), established by the Affordable Care Act, ties a hospital's payments to its readmission rates--with penalties for hospitals that exceed a national benchmark--to encourage hospitals to reduce avoidable readmissions. This new Commonwealth Fund analysis uses publicly reported 30-day hos­pital readmission rate data to examine whether safety-net hospitals are more likely to have higher readmission rates, compared with other hospitals. Results of this analysis find that safety-net hospitals are 30 percent more likely to have 30-day hospital readmission rates above the national average, compared with non-safety-net hospitals, and will therefore be disproportionately impacted by the HRRP. Policy solutions to help safety-net hospi­tals reduce their readmission rates include targeting quality improvement initiatives for safety-net hospitals; ensuring that broader delivery system improvements include safety-net hospitals and care delivery systems; and enhancing bundled payment rates to account for socioeconomic risk factors.

MeSH terms

  • Accountable Care Organizations
  • Centers for Medicare and Medicaid Services, U.S.
  • Health Policy*
  • Heart Failure
  • Hospitals*
  • Humans
  • Medicaid
  • Medicare
  • Myocardial Infarction
  • Patient Protection and Affordable Care Act
  • Patient Readmission / statistics & numerical data*
  • Pneumonia
  • Quality Assurance, Health Care*
  • Quality Improvement*
  • Reimbursement Mechanisms*
  • Reimbursement, Disproportionate Share / statistics & numerical data*
  • Risk Factors
  • Socioeconomic Factors
  • Uncompensated Care
  • United States
  • Vulnerable Populations