Trends in readmission rates for safety net hospitals and non-safety net hospitals in the era of the US Hospital Readmission Reduction Program: A retrospective time series analysis using Medicare administrative claims data from 2008 to 2015

BMJ Open

Volumn 7, Issue 7, 2017, Pages

  Salerno, Amy M ^a,b   Horwitz, Leora I ^c,d,e   Kwon, Ji Young ^b   Herrin, Jeph ^a,f   Grady, Jacqueline N ^b   Lin, Zhenqiu ^b   Ross, Joseph S ^a,b,g   Bernheim, Susannah M ^a,b  

^a YALE UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b YALE NEW HAVEN HOSPITAL   (United States)

^c NEW YORK UNIVERSITY MEDICAL CENTER   (United States)

^d NEW YORK UNIVERSITY SCHOOL OF MEDICINE   (United States)

^e New York School of Medicine   (United States)

^f Health Research and Educational Trust   (United States)

^g YALE UNIVERSITY   (United States)

Author keywords

GENERAL MEDICINE (see Internal Medicine); Health policy; Quality in health care

Indexed keywords

ADMINISTRATIVE CLAIMS (HEALTH CARE); ADULT; AGED; ARTICLE; CONTROLLED STUDY; HEALTH CARE DISPARITY; HOSPITAL READMISSION; HUMAN; MAJOR CLINICAL STUDY; MEDICAID; MEDICARE; MULTICENTER STUDY; OBSERVATIONAL STUDY; RETROSPECTIVE STUDY; SAFETY NET HOSPITAL; SOCIAL STATUS; TIME SERIES ANALYSIS; TREND STUDY; ECONOMICS; EPIDEMIOLOGY; FEMALE; INSURANCE; MALE; MEDICAL FEE; STATISTICAL MODEL; STATISTICS AND NUMERICAL DATA; TRENDS; UNITED STATES; VERY ELDERLY;

AGED; AGED, 80 AND OVER; FEE-FOR-SERVICE PLANS; FEMALE; HUMANS; INSURANCE CLAIM REVIEW; INTERRUPTED TIME SERIES ANALYSIS; LINEAR MODELS; LOGISTIC MODELS; MALE; MEDICARE; PATIENT READMISSION; RETROSPECTIVE STUDIES; SAFETY-NET PROVIDERS; UNITED STATES;

EID: 85024370402     PISSN: None     EISSN: 20446055     Source Type: Journal    
DOI: 10.1136/bmjopen-2017-016149     Document Type: Article

References (27)

1. Hospital Readmission Reduction Program. Patient protection and Affordable Care Act S 2025. (23 Mar 2010).
2. Joynt KE, Sarma N, Epstein AM, et al. Challenges in reducing readmissions: lessons from leadership and frontline personnel at eight minority-serving hospitals. Jt Comm J Qual Patient Saf 2014;40:435-AP7.
3. Bradley EH, Curry L, Horwitz LI, et al. Contemporary evidence about hospital strategies for reducing 30-day readmissions: a national study. J Am Coll Cardiol 2012;60:607-14.
4. Medicare Hospital Quality Chartbook: Performance Report on Outcome Measures September 2014: Prepared by Yale New Haven Health Services Corporation Center for Outcomes Research and Evaluation for Medicare and Medicaid Services, 2014.
5. Gerhardt G, Yemane A, Hickman P, et al. Medicare readmission rates showed meaningful decline in 2012. Medicare Medicaid Res Rev 2013;3:E1-E12.
6. Zuckerman RB, Sheingold SH, Orav EJ, et al. Readmissions, observation, and the hospital readmissions reduction program. N Engl J Med 2016;374:1543-51.
7. Boccuti GC C. Aiming for fewer hospital U-turns. the Medicare Hospital Readmission Reduction Program. The Henry Kaiser Family Foundation Issue Brief. http://kff.org/medicare/issue-brief/aiming-forfewer-hospital-u-turns-the-medicare-hospital-readmission-reductionprogram/. (29 Jan 2015).
8. Gilman M, Adams EK, Hockenberry JM, et al. California safety-net hospitals likely to be penalized by ACA value, readmission, and meaningful-use programs. Health Aff 2014;33:1314-22.
9. Joynt KE, Jha AK. Characteristics of hospitals receiving penalties under the Hospital Readmissions Reduction Program. JAMA 2013;309:342-3.
10. Barnett ML, Hsu J, McWilliams JM. Patient characteristics and differences in hospital readmission rates. JAMA Intern Med 2015;175:1803.
11. Gu Q, Koenig L, Faerberg J, et al. The medicare hospital readmissions reduction program: potential unintended consequences for hospitals serving vulnerable populations. Health Serv Res 2014;49:818-37.
12. Calvillo-King L, Arnold D, Eubank KJ, et al. Impact of social factors on risk of readmission or mortality in pneumonia and heart failure: systematic review. J Gen Intern Med 2013;28:269-82.
13. Herrin J, St Andre J, Kenward K, et al. Community factors and hospital readmission rates. Health Serv Res 2015;50:20-39.
14. Ross JS, Bernheim SM, Lin Z, et al. Based on key measures, care quality for Medicare enrollees at safety-net and non-safety-net hospitals was almost equal. Health Aff 2012;31:1739-48.
15. Gilman M, Hockenberry JM, Adams EK, et al. The financial effect of value-based purchasing and the hospital readmissions reduction program on safety-net hospitals in 2014: a Cohort Study. Ann Intern Med 2015;163:427-36.
16. Sheingold SH, Zuckerman R, Shartzer A. Understanding medicare hospital readmission rates and differing penalties between safety-Net and other hospitals. Health Aff 2016;35:124-31.
17. Carey K, Lin MY. Hospital readmissions reduction program: safetynet hospitals show improvement, modifications to penalty formula still needed. Health Aff 2016;35:1918-23.
18. American Community Survey Information Guide. commerce USDo. 2013.
19. Evaluation YNHHSCCfORa. 2015 Measure Updates and Specification Report Hospital-Wide All-Cause Unplanned Readmission Measure - Version 4.0. (Mar 2015).
20. Peter Cunningham LF. Environmental Scan to Identify the Major Research Questions and Metrics for Monitoring the Effects of the Affordable Care Act on Safety Net Hospitals. In: Center for Studying Health System Change. ASPE, 2013.
21. Agency for Healthcare Research and Quality R, MD. Creation of New Race-Ethnicity Codes and Socioeconomic Status (SES) Indicators for Medicare Beneficiaries. 2014. http://www.ahrq.gov/research/findings/final-reports/medicareindicators/index.html.
22. Bureau of Economic Analysis UDoC. News Release: Real Personal Income for States and Metropolitan Areas. 2016. http://www.bea.gov/newsreleases/regional/rpp/2016/pdf/rpp0716.pdf.
23. Gaskin DJ, Hadley J, Freeman VG. Are urban safety-net hospitals losing low-risk medicaid maternity patients? Health Serv Res 2001;36(1 Pt 1):25-51.
24. Jenq GY, Doyle MM, Belton BM, et al. Quasi-experimental evaluation of the effectiveness of a large-scale readmission reduction program. JAMA Intern Med 2016;176:681.
25. Coleman EA, Parry C, Chalmers S, et al. The care transitions intervention: results of a randomized controlled trial. Arch Intern Med 2006;166:1822-8.
26. Jack BW, Chetty VK, Anthony D, et al. A reengineered hospital discharge program to decrease rehospitalization: a randomized trial. Ann Intern Med 2009;150:178-87.
27. Naylor MD, Brooten D, Campbell R, et al. Comprehensive discharge planning and home follow-up of hospitalized elders: a randomized clinical trial. JAMA 1999;281:613-20.