New analysis: Readmissions penalties don’t increase mortality for heart failure
New research from the Medicare Payment Advisory Commission (MedPAC) refutes the assertion of a JAMA Cardiology study that the Hospital Readmissions Reduction Program (HRRP) is associated with increased mortality for heart failure patients.
That study showed readmission rates for heart failure had decreased since the HRRP began penalizing hospitals, but risk-adjusted mortality rates increased from 7.2 to 8.6 percent and 30 days, and from 31.3 to 36.3 percent at one year.
MedPAC analysts Craig Lisk, MS, and Jeff Stensland, PhD, said those findings could be explained by hospitals being more prudent on which patients they admit in the first place.
“As easier cases are no longer admitted to the hospital, patient complexity increases and we would expect an increase in the raw, meaning not risk-adjusted mortality,” Stensland said. “Given the declines in initial admissions we see, increasing raw mortality rates should not be unexpected. … The bottom line is that the data we have suggest that declines in readmissions are not causing increases in mortality.”
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