Press Release


For Immediate Release Contact

 

Sue Ducat
Director of Communications
(301) 841-9962
sducat@projecthope.org

Christine Clayton
Robert Wood Johnson Foundation
609-627-5937
media@rwjf.org

   

From Health Affairs:

 

Medicare Hospital Readmissions Reduction Program

 

Bethesda, MD --A new Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation describes the Medicare Hospital Readmissions Reductions Program (HRRP), established as part of the Affordable Care Act. This program imposes financial penalties on hospitals with higher than expected readmissions. The program aims to create an incentive for hospitals to reduce the number of patients who return to the hospital within 30 days for treatment of three key conditions: acute myocardial infarction (that is, heart attack), heart failure, or pneumonia. The HRRP, in operation for only two years, already has shown results. Despite this success, some policy makers fear unintended consequences for safety-net hospitals, potentially putting vulnerable populations at risk.

Some of the topics covered in this brief include:

  • What's the background and what's in the law? The policy brief traces the evolution of the HRRP from 2009, when the Centers for Medicare and Medicaid Services began public reporting of hospital readmissions rates. Prior to the enactment of the Affordable Care Act, Medicare hospital payment policies may have inadvertently contributed to high readmission rates. Medicare pays most hospitals a fixed cost per admission, providing no financial reimbursements for postdischarge follow-up and other measures that could reduce readmissions. Additionally, the brief explains how "expected readmissions rates" are calculated, and which conditions and situations are excluded from penalties for excessive readmissions.

  • What's the debate? Although there is widespread support for the goals of the HRRP, an array of policy makers and industry leaders have questioned whether hospitals are being treated fairly, particularly those that care for the sickest and most vulnerable patients. Postacute provider performance after all is an important factor in determining readmissions, yet it is beyond the hospital's control. The brief also explains some of the suggested changes to the HRRP, such as adjusting how penalties are computed and how patients' socioeconomic status can be taken into account.

  • What's next? Next year, the Medicare HRRP will cover two additional conditions: elective hip or knee replacement and congestive obstructive pulmonary disease. Over time, hospitals will continue to experiment with various strategies for reducing readmissions. One consequence of the program may be a growing recognition that reducing readmissions is a shared responsibility that belongs not only to hospitals but also to patients and their caregivers.
 
About Health Policy Briefs

Health Policy Briefs are aimed at policy makers, congressional staffers, and others who need short, jargon-free explanations of health policy basics. The briefs, which are reviewed by experts in the field, include competing arguments on policy proposals and the relevant research supporting each perspective.

Previous policy briefs have addressed:

  • Navigators and Assisters. Trained counselors and organizations are helping consumers enroll in health plans through the Affordable Care Act's new insurance Marketplaces.

  • Biosimilars. To encourage competition, the health care law directs the FDA to develop an accelerated approval pathway for follow-on versions of original biologic products.

  • Excise Tax on 'Cadillac' Plans. To slow growing costs and finance expanded coverage, the Affordable Care Act imposes an excise tax on high-cost health plans to take effect in 2018.
 
About Health Affairs
 

Health Affairs is the leading journal at the intersection of health, health care, and policy. Published by Project HOPE, the peer-reviewed journal appears each month in print, with additional Web First papers published periodically at www.healthaffairs.org. The full text of each Health Affairs Web First paper is available free of charge to all website visitors for a one-week period following posting, after which it switches to pay-per-view for nonsubscribers. Web First papers are supported in part by a grant from The Commonwealth Fund. You can also find the journal on Facebook and Twitter. Read daily perspectives on Health Affairs Blog. Download our podcasts, including monthly Narrative Matters essays, on iTunes. Tap into Health Affairs content with the new iPad app.