News: JAMA study suggests lower readmissions are linked to higher death risks

As many as 10,000 heart failure patients could die prematurely each year because of misguided efforts that keep them out of the hospital to avoid the financial penalties attached to higher readmissions, according to a study published in the Journal of the America Medical Association (JAMA), HealthLeaders Media reported.

Although intended to improve patient care and reduce the need to re-admit patients to the hospital, the study found the Hospital Readmission Reduction Program actually resulted in a 30-day and one-year risk adjusted mortality. The study analyzed 155,245 fee-for-service Medicare beneficiaries hospitalized for heart failure between January 1, 2006, and December 31, 2014 at 416 facilities nationwide.

“If we were to extrapolate [these findings] to all Medicare beneficiaries hospitalized with heart failure, we are talking about maybe 10,000 patients a year with heart failure losing their lives as a consequence of this program,” study co-author Gregg C. Fonarow, MD, told HealthLeaders Media. Fonarow is a researcher and professor of cardiovascular medicine at UCLA.

According to Fonarow, the financial penalties linked to the 30-day readmissions program are up to 3% of every Medicare dollar. On the other hand, the strongest penalty linked to even a 100% mortality rate would only be 0.2% of the hospital’s Medicare revenue.

“That’s sending a message from a financial standpoint that it’s more important to reduce readmissions than to be focused on patient safety or mortality,” he told HealthLeaders Media. 

Editor’s note: To read the interview with Fonarow conducted by HealthLeaders Media, click here. To read the entire study published by JAMA, click here. To read about another JAMA study linking readmissions and mortality rates, click here.