ACA Program Penalties Drop Hospital Readmissions

HealthDay News — There is a greater reduction in readmission rates at hospitals subject to penalties under the Affordable Care Act’s Hospital Readmission Reduction Program (HRRP), according to a study published in the Journal of the American Medical Association.

Nihar R. Desai, MD, MPH, from the Yale University School of Medicine in New Haven, Conn., and colleagues compared trends in readmission rates for target and non-target conditions in a retrospective cohort study of Medicare fee-for-service beneficiaries older than 64 years. Data were included for 48,137,102 hospitalizations of 20,351,161 Medicare beneficiaries from 2,214 penalty hospitals and 1,283 non-penalty hospitals.

The researchers found that prior to the HRRP announcement (January 2008 to March 2010), readmission rates were stable across hospitals (except for acute myocardial infarction at non-penalty hospitals). Readmission rates for target and non-target conditions declined significantly faster for patients at hospitals later subject to financial penalties versus those at non-penalized hospitals following announcement of HRRP in March 2010. The decline in readmission rates was significantly faster for target conditions versus non-target conditions for penalty hospitals; readmissions for target conditions declined similarly or more slowly than non-target conditions among non-penalty hospitals. The rate of change for readmission rates plateaued after HRRP implementation in October 2012, with the greatest relative change seen for hospitals subject to financial penalty.

“Medicare fee-for-service patients at hospitals subject to penalties under the HRRP had greater reductions in readmission rates compared with those at non-penalized hospitals,” the authors write.

Several authors disclosed financial ties to the pharmaceutical and health care industries.

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Desai NR, Ross JS, Kwon JY, et al. Association between hospital penalty status under the hospital readmission reduction program and readmission rates for target and nontarget conditions. JAMA. 2016;316(24):2647-2656. doi: 10.1001/jama.2016.18533