News: BMJ study latest to claim readmission reductions may be misleading

Hospitals may be trying to avoid readmitting patients in order to sidestep CMS penalties under Hospital Readmissions Reduction Program (HRRP), according to a new study published in The BMJ.

HRRP began under hospital value-based purchasing in 2012 as a way to improve healthcare quality by disincentivizing readmissions through financial penalties. In theory, the hospital should provide optimal care and discharge planning so the patient wouldn’t need emergent care for the same condition within a set time frame.

The study, which used data from 2012 to 2015, found that patients may be receiving outpatient treatment in emergency departments and observation areas rather than being readmitted for inpatient stays.

A July study in Health Affairs, claimed that benefits from the HRRP may have plateaued as hospitals adjusted their practices to improve as much as possible. In the last few years, HRRP has expanded to include other conditions, including heart bypass surgery and sepsis-related pneumonia, with penalties of up to 3% of Medicare earnings. The HealthAffairs study indicated that adding on penalties for other conditions likely won’t “further bend” the readmission curve toward improved outcomes.

The BMJ researchers conclude that CMS should measure not just hospital readmissions but all hospital revisits “to strengthen incentives to improve quality of care and provide a more comprehensive assessment of care quality and healthcare use in the post-discharge period.”

Editor’s Note: To read the related article “Painting the picture of patient care for population health directives,” click here. To read the article regarding the Health Affairs study, click here. To read the BMJ study, click here.