Higher Readmissions at Safety-Net Hospitals and Potential Policy Solutions

December 10, 2012 | Volume 34

Authors: Julia Berenson, M.Sc., and Anthony Shih, M.D., M.P.H.,
Contact: Julia Berenson, M.Sc., Senior Research Associate, The Commonwealth Fund, jb@cmwf.org
Editor: Deborah Lorber

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Overview

The Hospital Readmissions Reduction Program (HRRP), established by the Affordable Care Act, ties a hospital’s payments to its readmission rates—with penalties for hospitals that exceed a national benchmark—to encourage hospitals to reduce avoidable readmissions. This new Commonwealth Fund analysis uses publicly reported 30-day hospital readmission rate data to examine whether safety-net hospitals are more likely to have higher readmission rates, compared with other hospitals. Results of this analysis find that safety-net hospitals are 30 percent more likely to have 30-day hospital readmission rates above the national average, compared with non–safety-net hospitals, and will therefore be disproportionately impacted by the HRRP. Policy solutions to help safety-net hospitals reduce their readmission rates include targeting quality improvement initiatives for safety-net hospitals; ensuring that broader delivery system improvements include safety-net hospitals and care delivery systems; and enhancing bundled payment rates to account for socioeconomic risk factors.

Citation

J. Berenson and A. Shih, Higher Readmissions at Safety-Net Hospitals and Potential Policy Solutions, The Commonwealth Fund, December 2012.