Skip to main content
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Digital Health
    • Transformation
    • ESG
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Opinion
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • ESG: The Implementation Imperative Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Hospital at Home
    • - Workplace of the Future
    • - Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
  • Data Center
    • Data Center Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • Newsletters
  • MORE+
    • Contact Us
    • Advertise
    • Media Kit
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Providers
July 19, 2017 01:00 AM

Lowering readmission rates does not harm patient safety

Alex Kacik
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print

    As hospitals continue to lower readmission rates and satisfy new value-based incentives, mortality rates have also dropped, signaling improvement in care quality, a new study found.

    Hospitals have successfully reduced readmission rates over the past several years, as new payment incentives penalize providers that have patients return within 30 days after they are discharged. But some worry that may lead to hospitals sending patients who should be admitted home from the emergency department or providers becoming distracted from other quality improvement efforts.

    So far, those concerns are unfounded. A new study published in JAMA analyzed about 5 million Medicare fee-for-service hospitalizations between 2008 and 2014 and found that 30-day readmission rates declined for all conditions studied—heart failure, acute myocardial infarction and pneumonia. While 30-day mortality rates slightly increased for heart failure patients over that time, they dropped for acute myocardial patients and remained steady for those with pneumonia.

    THE TAKEAWAY

    As hospitals continue to lower readmission rates and satisfy new value-based incentives, mortality rates have also dropped, signaling improvement in care equality.

    The data suggest that hospitals that lowered their readmission rates also tended to have small reductions in mortality, said Dr. Karen Joynt, an assistant professor of medicine at Washington University School of Medicine.

    "This is certainly good news," she wrote in an accompanying editorial. "There is an emerging literature on strategies that hospitals are using to reduce readmissions, the majority of which relate to improving coordination, communication and cooperation among physicians and other health care professionals and across care settings. These strategies are patient centered and, when successful, should be adopted by all hospitals, regardless of baseline readmission rates."

    Hospitals have lowered readmissions through improved transitional and post-acute care by better preparing patients and families for discharge, integrating care across settings and following up in a timely manner, researchers said.

    "Thousands and thousands of readmissions are being avoided every year without any evidence of people being harmed. That is a victory of improving the quality of care," study co-author Dr. Harlan Krumholz, a professor of cardiology at Yale University, said in a statement.

    Still, it is important to study the potential unintended consequences of various payment incentives, Joynt said.

    The Hospital Readmissions Reduction Program implemented under the ACA penalizes providers up to 3% of Medicare inpatient payments for those who return to the hospital within 30 days. On the other hand, the federal Hospital Value-Based Purchasing program levies penalties up to 2% of payments based on mortality measures, patient experience, safety and efficiency. This strikes an imbalance favoring reducing readmissions over care quality, she said.

    Readmission rates for the three conditions studied by the researchers declined from 21.5% to 17.8% between 2007 and 2015, the study found. Readmission rates significantly declined after the readmissions reductions program was announced but have flattened since penalties began in 2012, research shows. That could be chalked up to providers already maximizing "low-hanging-fruit" solutions and needing to move the needle further with longer-term investments or providers opting to pay the penalty rather than change, which averaged around $158,000 per hospital in 2015, Joynt said.

    Researchers recommended tweaking the readmission program to accommodate larger hospitals that provide high-quality care but are disproportionally penalized because they care for the sickest populations. Also, under the program, hospitals can reduce readmissions and still receive an equal or higher penalty compared with the prior year because providers are graded on a curve, Joynt said, which could disincentive providers to improve.

    "As more money is 'at risk' under value-based payment arrangements such as the HRRP, getting risk adjustment right is ever more crucial to ensure that such arrangements are as fair as possible and do not unduly disadvantage hospitals caring for the sickest, most vulnerable populations," she wrote.

    An​ edited​ version​ of​ this​ story​ can​ also​ be​ found​ in​ Modern​ Healthcare's​ July​ 24​ print​ edition.

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    merger-arrows-money_i.png
    Option Care Health CEO stands by $3.6B Amedisys deal
    Why home is becoming the future for hospitals
    Why home is becoming the future for hospitals
    Most Popular
    1
    More healthcare organizations at risk of credit default, Moody's says
    2
    Centene fills out senior executive team with new president, COO
    3
    SCAN, CareOregon plan to merge into the HealthRight Group
    4
    Blue Cross Blue Shield of Michigan unveils big push that lets physicians take on risk, reap rewards
    5
    Bright Health weighs reverse stock split as delisting looms
    Sponsored Content
    Modern Healthcare A.M. Newsletter: Sign up to receive a comprehensive weekday morning newsletter designed for busy healthcare executives who need the latest and most important healthcare news and analysis.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Digital Health
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • ESG
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Opinion
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Hospital at Home
        • - Workplace of the Future
        • - Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • Data Center
      • Data Center Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • Newsletters
    • MORE+
      • Contact Us
      • Advertise
      • Media Kit
      • Jobs
      • People on the Move
      • Reprints & Licensing