September 6th, 2013
Kaiser Health News recently published a list of 2,225 hospitals that will be penalized through the second year of the federal government’s Hospital Readmissions Reduction Program (HRRP). The list indicated the percentage that the hospitals’ base Medicare reimbursements will be reduced (0.38% on average) due to “excess” readmissions when the next round of penalties takes effect on October 1, 2013.
News of the release brought with it a renewed focus on the program and the efficacy of its approach, which is designed to counter perverse fee-for-service incentives in which hospitals are financially rewarded for readmitted patients. A chorus of concerns related to the methodology used to calculate “excess” readmissions has been raised by hospitals and researchers since the program was mandated by the Affordable Care Act.
Transitioning the health system toward value. Beyond methodological concerns, there is a question of the long-term policy role the HRRP should play as Medicare and other payers promote broader payment and delivery system reforms such as value-based purchasing, bundled payments, accountable care, and medical homes. These reforms may offer more positive and stronger incentives for improvement across the care continuum than the HRRP penalties. However, it is too soon to judge the effectiveness of these reforms, nor is it clear how quickly and widely they will be adopted.Read the rest of this entry »