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Study links CMS readmission-reduction program to higher death rates

— Photo by Daquella Manera

A new study in JAMA Cardiology  found that  CMS’s push to reduce hospital-readmission rates may be leading to modestly higher  death rates for patients with heart failure.

After looking at data on more than 115,000 Medicare fee-for-service beneficiaries at 416 hospitals, researchers  found that while the Hospital Readmission Reduction Program (HRRP) was  linked to reduced readmission rates for patients with heart failure, it was also linked to higher death rates for them.

The study, in JAMA Cardiology, said that the 30-day adjusted readmission rate declined  to 18.4 percent from 20 percent before HRRP  but  30-day mortality rates rose to 8.6 percent from 7.2 percent. For one-year rates, the readmission rates declined to 56.3 percent from 57.2 percent, while the mortality rate rose to 36.3 percent from 31.3 percent.

Gregg Fonarow, M.D., the study’s senior author and co-chief of the David Geffen School of Medicine at University of California at Los Angeles Department of Cardiology, that the study suggests  that HRRP “incentivized strategies that unintentionally harmed patients with heart failure.”

“The policy should focus on incentivizing improving quality and patient-centered outcomes of those with heart failure and not on a misguided utilization metric of rehospitalizations,”  he said.

The same researchers are now studying which patients and hospitals are most affected by the apparent HRRP-death-rate link.

To read the study, please hit this link.

CMS seeks to adjust readmission penalties to account for duel-eligibles


The Centers for Medicare & Medicaid Services wants to adjust penalties in its Hospital Readmissions Reduction Program according to a hospital’s proportion of dual-eligible (Medicare and Medicaid) patients — a move long supported by hospital-industry stakeholders.

The proposed rule would take effect in fiscal 2019. In it, the CMS laid out several approaches  for determining   hospitals’ proportion of dually eligible patients and other key metrics.The change stems from the 21st Century Cures Act,  enacted last December. The law required Medicare to consider patient background when calculating payment reductions to hospitals under the Hospital Readmission Reduction Program, and to adjust those penalties based on the proportion of patients  dually eligible for Medicare and Medicaid.

The  Medicare Payment Advisory Commission has reported that while these dual eligibles constituted 18 percent of beneficiaries they accounted for nearly a third of total Medicare fee-for-service spending in 2012.

To read more, please hit this link.


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