Is program to reduce hospital readmissions associated with a change in patient deaths?

Bottom Line: The Hospital Readmissions Reduction Program (HRRP) was created under the Affordable Care Act and hospitals face financial penalties for higher-than-expected 30-day readmission rates for patients with heart failure, heart attack and pneumonia. Lower hospital readmission rates for those conditions have been associated with the program but it was unclear if the program was associated with a change in patient deaths. This observational study included 8 million Medicare hospitalizations for heart failure, heart attack and pneumonia before and after HRRP was implemented. Study results suggest implementation of the HRRP was associated with an increase in deaths within 30 days after discharge for hospitalization for heart failure and pneumonia but not for heart attack. More research is needed to understand if the increase in 30-day postdischarge mortality is a result of the program, considering a lack of association with mortality within 45 days of hospital admission.

Authors: Robert W. Yeh, M.D., M.Sc., Beth Israel Deaconess Medical Center, Boston, and coauthors

Related Material: The editorial, “Unintended Harm Associated With the Hospital Readmissions Reduction Program,” by Gregg C. Fonarow, M.D., Ronald Reagan UCLA Medical Center, Los Angeles, is also available on the For The Media website.

To Learn More: The full study is available on the For The Media website.

(doi:10.1001/jama.2018.19232)

Editor’s Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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