Fiver years ago, lawmakers instituted the Hospital Readmission Reduction Program in an effort to bring down rising Medicare costs. The program encourages hospitals to reduce Medicare readmission rates by penalizing them financially if they do not. According to researchers at UCLA and Harvard University, though the policy indeed reduced re-hospitalizations, it is also linked with an increase in related mortality rates.
Using data from the American Heart Association’s Get With The Guidelines–Heart Failure program, a voluntary quality improvement initiative at hospitals across the country, as well as Medicare data, researchers compared heart failure patients’ readmission rates, mortality rates and characteristics, along with hospital characteristics, from January 2006 through December 2014.
While researchers do not take issue with the program's goals, they are concerned that its focus is to narrowly defined:
“To avoid the penalties, hospitals now have incentives to keep patients out of hospitals longer, possibly even if previously some of these patients would have been readmitted earlier for clinical reasons,” said first author Dr. Ankur Gupta, cardiovascular research fellow at the Brigham and Women’s Hospital, Harvard Medical School. “Therefore, this policy of reducing readmissions is aimed at reducing utilization for hospitals rather than having a direct focus on improving quality of patient care and outcomes.”