Participation in voluntary federal programs that push for quality improvements has a greater impact on reducing readmissions than financial penalties levied against hospitals for high rates alone, a new study finds.
Researchers at the University of Michigan examined records for patients treated for heart attack, heart failure or pneumonia between 2005 and 2015 at more than 2,800 U.S. hospitals and found that hospitals participating in one of at least three federal programs—Meaningful Use, accountable care organizations or bundled payments—saw 30-day readmission rates decrease by wider margins, according to a study published in JAMA Internal Medicine.
In 2010, before the Affordable Care Act was fully implemented, none of the hospitals in the study were enrolled in the programs, but by 2015 just 56 of the hospitals in the study were not enrolled in at least one. Those hospitals saw readmission rates decrease by 1.3% annually, which the researchers attributed to fines levied under the Centers for Medicare & Medicaid Services' Hospital Readmission Reduction Program.
Hospitals with an ACO saw a reduction of 2.1% each year, and participation solely in the Meaningful Use program led to reductions of 2.3% each year. Hospitals that participated in all three programs saw readmission rates drop by 2.9% per year, according to the study.
There were cost savings associated with the results, too, the researchers found. The three programs’ impact on readmissions accounted for cost savings in 2015 of nearly $32 million.
"This, to us, was encouraging and makes us think there is a reason to believe these value programs are reinforcing the broader push to value-based care," Andrew Ryan, Ph.D., the study’s lead author and an associate professor in the UM School of Public Health Department of Health Management and Policy, said in an announcement.
"Our findings show the importance of a multi-pronged Medicare strategy to improve quality and value."
The results also suggest that these innovations work better in tandem, and that providers should look at the “synergy” to achieve the ultimate goal of higher quality care, he said. For instance, providers with an effective electronic health record can use the program to make clinical notes that improve care coordination.