Spillover Effects of the Hospital Readmission Program

The Center for Medicare and Medicaid Services (CMS) aims to reduce hospital readmissions and improve health care outcomes by reducing payments to Inpatient Prospective Payment system hospitals with excess 30-day readmissions under the Affordable Care Act’s Hospital Readmissions Reduction Program (HRRP) and by publically reporting on readmission rates for select conditions. As hospitals implement strategies to reduce readmissions under these initiatives, it is hypothesized that non-targeted populations and conditions may also see improvements in readmissions as result of the spill-over effects. This was demonstrated by reduced rates between 2009 and 2012; however, it remains unclear whether these reductions were the result of public reporting, anticipated financial penalties, or other factors. This project will examine the effect of Medicare hospital readmission reduction initiatives on 1) national Medicare readmission rates by hospital type for HRRP conditions; 2) non-Medicare readmission rates in California, Florida, and Washington; and 3) readmission rates across all conditions. This work will result in a manuscript for peer review submission and will shed light on the extent to which Medicare readmission reduction initiatives can drive broader, system-wide improvement in outcomes and costs.