January 10, 2019

Reduced readmissions credited to HRRP overstated

By: Judy Mathias
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Editor’s Note

Medicare’s Hospital Readmissions Reduction Program (HRRP), which penalizes readmissions for several targeted conditions, has been credited with lowering readmission rates; however, these reductions now appear to be overstated, this study finds.

A concurrent change in electronic transaction standards that increased diagnostic coding allowed hospitals to document a larger number of diagnoses per claim, which created the illusion of reducing readmission rates.

Accounting for the change in standards lessens the reduction in readmissions by nearly 50%, and further adjusting for differences in pre-HRRP readmission rates finds that declines in readmissions were statistically indistinguishable from declines in two control samples.

The researchers concluded that either HRRP has had no effect on readmissions, or it has led to a reduction that is only half as large as prior estimates.

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