AHA calls for changes in hospital readmission penalties

The American Hospital Association (AHA) has joined the chorus calling for changes in the Hospital Readmissions Reduction Program (HRRP) to avoid penalizing facilities for readmission factors beyond their control.

The AHA's report, "Rethinking the Hospital Readmissions Reduction Program," is critical of the HRRP, a component of the Affordable Care Act that penalizes hospitals with higher-than-expected readmissions for certain clinical conditions.

"While hospital readmissions are declining, there are serious questions about how the HRRP assesses penalties that affect the fairness and long-term sustainability of the program," the report states.

It's easy to see what the HRRP would be unpopular in the healthcare sector. As of October, the Centers for Medicare & Medicaid Services (CMS) was set to hit a record number of hospitals with readmission-related financial penalties, as well as increase the fine ceiling to as much as 3 percent of Medicare reimbursements, according to FierceHealthcare. And another report pointed out that even hospitals that reduced readmissions might be penalized due to the way CMS collects its data.

Other research has backed up the AHA's claim that many readmission factors--such as socioeconomic status and lack of access to support systems--are outside of hospitals' control. For example, the AHA report points out that Medicare beneficiaries with six or more chronic conditions have a readmission rate of 25 percent, compared to 9 percent for those with one or no chronic conditions. Thus, hospitals shouldn't be penalized "simply because they treat more complex patients," the report states.

One recently introduced piece of legislation does attempt to make the HRRP more fair by taking sociodemographic factors into account, FierceHealthcare reported, an initiative AHA Executive Vice President Rick Pollack strongly supported in a statement about the report. "This recalibration ensures hospital performance is compared equally while maintaining an incentive for all hospitals to reduce unnecessary readmissions," he said.

In a lecture during the American College of Healthcare Executives' Congress in Chicago this week, National Quality Forum CEO Christine Cassel also mentioned the effort to retool the readmissions-reduction program in the context of her organization's goal to improve all healthcare quality measures, FierceHealthcare reported.

To learn more:
- check out the report
- here's the statement

Related Stories:
Bill would factor demographics into readmission penalties
Readmission penalties reach record high
Hospital performance not the driving force in readmissions
Readmission reduction: A losing battle?
3 ways to make readmission policies fair for hospitals
Hospitals that reduce readmissions still hit with penalties
Early results show slow progress in CMS readmissions programs

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