MedPAC ’s Proposed “Reforms” Should Be Tested Before They’re Implemented: CMS’s Hospital Readmissions Reduction Program Is Exhibit A

This report card is grossly inaccurate even though it relies on medical records data as well as claims data.) By the late 1990s, conventional wisdom among health policy “thought leaders” had elevated readmission rates to the same status as mortality rates – it was a legitimate quality measure that could be safely administered to thousands of hospitals and millions of patients. However, the conventional wisdom remained unproven by the early 2000s, and remains unproven to this day. “[T]he link between early readmission and quality of care is still uncertain,” is how five experts put it in a 2004 article. “[T]he association between the HRRP implementation and mortality is not known,” reported Gupta et al. in January 2018. “[T]he suitability of early re-hospitalization as a correct target for good medical practice is highly debated,” said Palazzouli et al. in a September 2018 article. The absence of evidence did not stop MedPAC from endorsing the emerging folklore that hospitals can reduce readmissions by spending more money on “care management services” (reconciling drug prescriptions prior to discharge, for example) and, therefore, readmission rates should be treated as quality indicators. In Chapter 5 of its June 2007 report to Congress, MedPAC recommended that CMS punish hospitals for “avoidable” readmissions. In that chapter MedPAC failed to offer evidence supporting their diagnosis (that unnecessary readmissions are occurring at very high rates), ...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Medicare Politics ACA Affordable Care Act CHIP CMS Congress hospital readmissions Kip Sullivan MACRA MedPAC P4P Pay for Performance Source Type: blogs