Adjusting for social risk factors impacts performance and penalties in the hospital readmissions reduction program.

ABSTRACT:

Objective

Medicare's Hospital Readmissions Reduction Program (HRRP) does not account for social risk factors in risk adjustment, and this may lead the program to unfairly penalize safety-net hospitals. Our objective was to determine the impact of adjusting for social risk factors on HRRP penalties.

Study design

Retrospective cohort study.

Data sources/study setting

Claims data for 2 952 605 fee-for-service Medicare beneficiaries with acute myocardial infarction (AMI), congestive heart failure (CHF) or pneumonia from December 2012 to November 2015.

Principal findings

Poverty, disability, housing instability, residence in a disadvantaged neighborhood, and hospital population from a disadvantaged neighborhood were associated with higher readmission rates. Under cu

SUBMITTER: Joynt Maddox KE 

PROVIDER: S-EPMC6407348 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature