{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"submitter":["Yang Z"],"funding":["NIA NIH HHS"],"pagination":["469580211064836"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC8949751"],"repository":["biostudies-literature"],"omics_type":["Unknown"],"volume":["59"],"pubmed_abstract":["Since the implementation of Medicare's Hospital Readmissions Reduction Program (HRRP), safety-net hospitals have received a disproportionate share of financial penalties for excess readmissions, raising concerns about the fairness of the policy. In response, the HRRP now stratifies hospitals into five quintiles by low-income Medicare (dual Medicare-Medicaid eligible) stay proportion and compares readmission rates within quintiles. To better understand the potential effects of the revised policy, we used difference-in-differences models to compare changes in 30-day readmission, 30-day mortality, and 90th-day community-dwelling rates after discharge of fee-for-service Medicare beneficiaries hospitalized for acute myocardial infarction, heart failure and pneumonia during 2007-2014, for hospitals in the highest (<i>N</i> = 677) and lowest (<i>N</i> = 678) dual-proportion quintiles before and after the original HRRP implementation in fiscal year 2013. We find that high dual-proportion hospitals lowered readmissions for all three conditions, while their patients' health outcomes remained largely stable. We also find that for heart failure, high dual-proportion hospitals reduced readmissions more than low dual-proportion hospitals, albeit with a relative increase in mortality. Contrary to concerns about fairness, our findings imply that, under the original HRRP, high dual-proportion hospitals improved readmissions performance generally without adverse effects on patients' health. Whether these gains could be retained under the new policy should be closely monitored."],"journal":["Inquiry : a journal of medical care organization, provision and financing"],"pubmed_title":["Did the Hospital Readmissions Reduction Program Reduce Readmissions without Hurting Patient Outcomes at High Dual-Proportion Hospitals Prior to Stratification?"],"pmcid":["PMC8949751"],"funding_grant_id":["R01 AG046838"],"pubmed_authors":["Popescu I","Yang Z","Huckfeldt P","Nuckols T","Escarce JJ","Sood N"],"additional_accession":[]},"is_claimable":false,"name":"Did the Hospital Readmissions Reduction Program Reduce Readmissions without Hurting Patient Outcomes at High Dual-Proportion Hospitals Prior to Stratification?","description":"Since the implementation of Medicare's Hospital Readmissions Reduction Program (HRRP), safety-net hospitals have received a disproportionate share of financial penalties for excess readmissions, raising concerns about the fairness of the policy. In response, the HRRP now stratifies hospitals into five quintiles by low-income Medicare (dual Medicare-Medicaid eligible) stay proportion and compares readmission rates within quintiles. To better understand the potential effects of the revised policy, we used difference-in-differences models to compare changes in 30-day readmission, 30-day mortality, and 90th-day community-dwelling rates after discharge of fee-for-service Medicare beneficiaries hospitalized for acute myocardial infarction, heart failure and pneumonia during 2007-2014, for hospitals in the highest (<i>N</i> = 677) and lowest (<i>N</i> = 678) dual-proportion quintiles before and after the original HRRP implementation in fiscal year 2013. We find that high dual-proportion hospitals lowered readmissions for all three conditions, while their patients' health outcomes remained largely stable. We also find that for heart failure, high dual-proportion hospitals reduced readmissions more than low dual-proportion hospitals, albeit with a relative increase in mortality. Contrary to concerns about fairness, our findings imply that, under the original HRRP, high dual-proportion hospitals improved readmissions performance generally without adverse effects on patients' health. Whether these gains could be retained under the new policy should be closely monitored.","dates":{"release":"2022-01-01T00:00:00Z","publication":"2022 Jan-Dec","modification":"2026-03-18T13:37:57.907Z","creation":"2025-04-06T10:58:00.635Z"},"accession":"S-EPMC8949751","cross_references":{"pubmed":["35317683"],"doi":["10.1177/00469580211064836"]}}