Medicare’s Readmission Reduction Program Meeting Goals, Says Study in Health Affairs

June 17, 2015 | Strategic Insights for Health System


Although some have postulated that hospitals will try to "game" the Medicare program to avoid financial penalties for preventable readmissions, a study in the June 2015 issue of Health Affairs finds no evidence of unintended effects associated with the Medicare Hospital Readmissions Reduction Program. The Medicare initiative penalizes hospitals for readmissions of Medicare patients with certain conditions that occur within 30 days of the initial hospitalization for the condition. The goal is for hospitals to better assess patients' readiness for discharge and to improve patients' transitions from the hospital to other healthcare settings. To avoid financial penalties, hospitals might also find alternatives to readmitting the patients, such as keeping them under observation status (which is not counted as an admission) or treating them as outpatients in the emergency department. The researchers examined 30-day readmissions among Medicare patients in New York for the three conditions initially targeted by the readmissions reduction program and compared them with Medicare patients with other conditions and with privately insured patients before and after introduction of the Medicare initiative.

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