Alexander T Sandhu1, Paul A Heidenreich2. 1. Stanford University School of Medicine, Stanford, CA. Electronic address: Ats114@stanford.edu. 2. Stanford University School of Medicine, Stanford, CA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA.
Abstract
BACKGROUND: The Hospital Readmission Reduction Program (HRRP), announced in 2010, penalizes hospitals with high readmissions for multiple conditions including heart failure. METHODS: We compared heart failure readmission and mortality rates in hospitals exposed to HRRP financial penalties with critical access hospitals (CAHs) not subject to the penalty between 2005 and 2016 using 3-year moving averages from Hospital Compare. RESULTS: After HRRP introduction, CAHs experienced a 0.60% annual decrease (95% CI: -0.61 to -0.59%) in heart failure readmissions. HRRP-exposed hospitals experienced an additional 0.13% annual decrease (95% CI: -0.14 to -0.12%) compared with CAHs. The association between HRRP penalties and mortality varied with model specifications. CONCLUSIONS: Using CAHs as a control group, we found the introduction of financial penalties was only associated with modest reductions in readmissions and an uncertain association with mortality. Cluster-randomized rollouts of health care policy interventions will allow us to better evaluate the impact of our interventions.
RCT Entities:
BACKGROUND: The Hospital Readmission Reduction Program (HRRP), announced in 2010, penalizes hospitals with high readmissions for multiple conditions including heart failure. METHODS: We compared heart failure readmission and mortality rates in hospitals exposed to HRRP financial penalties with critical access hospitals (CAHs) not subject to the penalty between 2005 and 2016 using 3-year moving averages from Hospital Compare. RESULTS: After HRRP introduction, CAHs experienced a 0.60% annual decrease (95% CI: -0.61 to -0.59%) in heart failure readmissions. HRRP-exposed hospitals experienced an additional 0.13% annual decrease (95% CI: -0.14 to -0.12%) compared with CAHs. The association between HRRP penalties and mortality varied with model specifications. CONCLUSIONS: Using CAHs as a control group, we found the introduction of financial penalties was only associated with modest reductions in readmissions and an uncertain association with mortality. Cluster-randomized rollouts of health care policy interventions will allow us to better evaluate the impact of our interventions.