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Unintended Harm Associated With the Hospital Readmissions Reduction Program

Unintended Harm Associated With the Hospital Readmissions Reduction Program Opinion EDITORIAL Unintended Harm Associated With the Hospital Readmissions Reduction Program Gregg C. Fonarow, MD Health care expenditures continue to increase in the United intended to incentivize hospitals to invest in improved tran- sitions of care, these penalties may have instead encouraged States, and there have been considerable efforts over the past decade to use health policies, financial incentives, and alter- restriction of necessary inpatient care within the first 30 days native payment models to address this important issue. Start- of hospital discharge through inappropriate triage strategies ing in 2007, the Centers for in emergency departments, increased use of observation stays Medicaid & Medicare Ser- when inpatient admissions would have been warranted, and Related article page 2542 vices (CMS) sought to reduce delayed clinically indicated readmissions just beyond dis- 8,9 early readmissions for common medical conditions among charge day 30. Medicare beneficiaries. The CMS policy approaches included It now appears that the reductions in readmissions for increasing transparency through public reporting of hospi- targeted conditions, including heart failure, acute myocardial tal 30-day risk standardized readmission rates (2007-2009 infarction, and pneumonia, after the implementation of the discharges) starting in 2009 and providing financial incen- HRRP were not the result of http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Unintended Harm Associated With the Hospital Readmissions Reduction Program

Fonarow, Gregg C.
JAMA , Volume 320 (24) – Dec 25, 2018
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References (10)

Publisher
American Medical Association
Copyright
Copyright 2018 American Medical Association. All Rights Reserved.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.2018.19325
Publisher site
See Article on Publisher Site

Abstract

Opinion EDITORIAL Unintended Harm Associated With the Hospital Readmissions Reduction Program Gregg C. Fonarow, MD Health care expenditures continue to increase in the United intended to incentivize hospitals to invest in improved tran- sitions of care, these penalties may have instead encouraged States, and there have been considerable efforts over the past decade to use health policies, financial incentives, and alter- restriction of necessary inpatient care within the first 30 days native payment models to address this important issue. Start- of hospital discharge through inappropriate triage strategies ing in 2007, the Centers for in emergency departments, increased use of observation stays Medicaid & Medicare Ser- when inpatient admissions would have been warranted, and Related article page 2542 vices (CMS) sought to reduce delayed clinically indicated readmissions just beyond dis- 8,9 early readmissions for common medical conditions among charge day 30. Medicare beneficiaries. The CMS policy approaches included It now appears that the reductions in readmissions for increasing transparency through public reporting of hospi- targeted conditions, including heart failure, acute myocardial tal 30-day risk standardized readmission rates (2007-2009 infarction, and pneumonia, after the implementation of the discharges) starting in 2009 and providing financial incen- HRRP were not the result of

Journal

JAMA – American Medical Association

Published: Dec 25, 2018

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