Did the HRRP lower readmissions at the cost of patient safety? The debate continues

The Hospital Readmissions Reduction Program (HRRP) has successfully slashed readmissions for heart failure, acute MI (AMI) and pneumonia without causing mortality increases, according to an analysis of Medicare data published in JAMA Network Open. But the author of an accompanying editorial isn’t convinced the results are so positive.

This topic has been a concern for researchers who worried the HRRP incentivized “inappropriate care strategies” for hospitals attempting to “game the system” and avoid paying penalties for 30-day readmission rates above the national average. 

The new study looked at all three conditions initially included in the HRRP, over a timeframe that spanned several years before the policy was announced in 2010 as well as a couple of years after the penalties for high readmissions went into effect in October 2012.

Ashish K. Jha, MD, MPH, isn’t convinced the data are entirely positive for the HRRP. Writing in a related editorial, he pointed out before the HRRP, inpatient mortality rates were declining for both AMI and heart failure. But after the policy was announced, that improvement flattened out.

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