Seeking Rational Approaches to Fixing Hospital Readmissions.

Abstract

Spurred by federal policy makers, US hospitals have made substantial efforts to address the problem of high rates of patients being readmitted to the hospital within 30 days of discharge. Underlying this policy focus is a straightforward idea: when patients are discharged from the hospital, with some exceptions, they shouldn’t have to return within 30 days. The Hospital Readmissions Reduction Program (HRRP), part of the Affordable Care Act (ACA), codified this notion by penalizing hospitals with higher-thanexpected readmission rates up to 3% of their totalMedicarepayments (http://go.cms .gov/1L93Lh4). The early evidence on HRRP’s effects was largely positive. Readmission rates declined nationally and the Centers for Medicare & Medicaid Services (CMS) touted these results (http://1.usa.gov /1k0tw2B) as evidence that the ACA had begun to bend the cost curve. From 2008 through 2013, the likelihood of a Medicare beneficiary being readmitted within 30 days decreased from 19.0% to 17.8%, translating to hundreds of millions of dollars in savings to Medicare.