Hospitals with high readmission rates penalized for the patients they serve

The Medicare Hospital Readmissions Reduction Program financially penalizes hospitals with higher than expected 30-day readmission rates by reducing annual reimbursements by up to 3%. Rates are adjusted only for patient age, gender, discharge diagnosis, and recent diagnoses.

This study from Harvard Medical School, Brigham and Women’s Hospital, and the Massachusetts General Hospital, Boston, assesses the extent to which patient characteristics account for differences in hospital readmission rates.

The results showed that Medicare patients admitted to hospitals with higher readmission rates were more likely to have characteristics associated with a higher probability of readmission, such as more chronic conditions, less education, fewer assets, worse self-reported health status, more depressive symptoms, worse cognition and physical functioning, and more difficulties with daily living activities.

The researchers concluded that patient characteristics not included in Medicare’s current risk-adjustment methods explained much of the difference in readmission risk. Hospitals with high readmission rates are being penalized largely because of the patients they serve.

—Barnett M L, Hsu J, McWilliams J M. Patient characteristics and differences in hospital readmission rates. JAMA Intern Med. Published online September 14, 2015.

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