News: Teaching, rural hospitals hit with fewer readmission penalties following CMS changes

CDI Strategies - Volume 13, Issue 16

Changes made to the Hospital Readmission Reduction Program (HRRP) aimed to address concerns related to unfair penalties seems to have worked, according to a new study published in the Journal of the American Medical Association (JAMA) Internal Medicine. The study found that 44.1% of teaching hospitals and 43.7% of rural hospitals experienced a lower penalty in 2019 compared to 2018, Modern Healthcare reported.

Hospitals (particularly safety net hospitals) said their complex patient case mix caused them to be unfairly penalized so Congress passed legislation requiring Medicare to account for sociodemographic factors (such as income, insurance status, and access to pharmacies, transportation for follow-up appointments and grocery stores) in the HRRP starting on October 1, 2018, AHA News reported.

Legislation also separated hospitals into five groups by similar proportion of patients who were dually eligible for Medicare and Medicaid.

“This was a positive change for the HRRP,” said Karen Joynt Maddox, MD, a Washington University cardiologist, assistant professor of medicine, and the study’s first author, in a news release from the Washington University School of Medicine in St. Louis. “Making the program more fair doesn’t take away from its goal, which is to use financial incentives to make hospitals think differently about care beyond their walls. Hospitals are increasingly working to provide a soft landing, including discharge planning and communication with outpatient-care providers.”

Editor’s note: To read the full JAMA study, click here. To read Modern Healthcare’s coverage of this story, click here. To read AHA News’ coverage of the HRRP changes, click here. To read the news release from the Washington University School of Medicine, click here

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