Medicare Readmission Rates Drop With Penalties Under Affordable Care Act
Penalties under the Affordable Care Act are linked to a rapid decrease in Medicare readmission rates.
HealthDay News -- Passage of the Medicare Hospital Readmissions Reduction Program (HRRP) under the Affordable Care Act is associated with a more rapid decrease in 30-day risk-standardized readmission rates (RSRRs), according to a study published in the Annals of Internal Medicine.
Jason H. Wasfy, MD, MPhil, from Massachusetts General Hospital in Boston, and colleagues examined whether passage of the HRRP correlated with acceleration in improvement in 30-day RSRRs after hospitalization for acute myocardial infarction, congestive heart failure, or pneumonia. Data were included for 15,170,008 Medicare patients discharged alive from 2000 to 2013. Thirty-day readmission rates were assessed after hospitalization at hospitals stratified by hospital performance: highest performance (0% penalty), average performance (>0% and <0.50% penalty), low performance (≥0.5% and <0.99% penalty), and lowest performance (≥0.99% penalty).
The researchers found that, of the 2868 hospitals serving 1,109,530 Medicare discharges annually, 30.1%, 44.0%, 16.8%, and 9.0% were highest, average, low, and lowest performers, respectively. After passage of the law, an additional 67.6, 74.8, 85.4, and 95.1 readmissions per 10,000 discharges were averted per year in the highest-, average-, low-, and lowest-performance groups, respectively, after controlling for prelaw trends.
"After passage of the HRRP, 30-day RSRRs for myocardial infarction, heart failure, and pneumonia decreased more rapidly than before the law's passage," the researchers wrote.
- Wasfy JH, Zigler CM, Choirat C, Wang Y, Dominici F, Yeh RW. Readmission rates after passage of the hospital readmissions reduction program: A pre–post analysis [published December 27, 2016]. Ann Intern Med. doi:10.7326/M16-0185.