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Study: Hospitalwide Readmission Measure Harder on Safety Net

A new study published in The New England Journal of Medicine suggests that shifting Hospital Readmissions Reduction Program (HRRP) readmission measures from condition-specific measures to a hospitalwide measure would substantially increase penalties for hospitals that serve a disproportionate number of low-income patients.

The HRRP now penalizes hospitals with high 30-day readmission rates for specific conditions, such as heart failure and pneumonia. But critics recommend switching to a hospitalwide readmission measure, which would broaden hospital eligibility and create incentives for improvement across more conditions. The study evaluated the number of hospitals eligible for penalties by analyzing Medicare claims from 2011 through 2013 and estimating the effects of changing readmission measures on average penalties for safety-net hospitals.

Of the 3,443 hospitals studied, 76 additional hospitals would be eligible for penalties under a hospitalwide readmission measure. The study found that moving to a hospitalwide measure, while only slightly increasing the number of hospitals eligible for penalties, would substantially increase the penalties for safety-net hospitals.

America’s Essential Hospitals has been a leading advocate for risk-adjustment based on socioeconomic status for measures in Medicare quality programs to ensure that hospitals caring for vulnerable patients are not disproportionately and unfairly penalized for the challenges their patients face.

Contact Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Emily Schweich is a communications manager at America's Essential Hospitals.

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