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

Conclusions reached by Gupta et al. and MedPAC In November of 2017 Ankur Gupta and 10 other experts in cardiovascular medicine published an article in JAMA Cardiology entitled, “Association of the Hospital Readmissions Reduction Program implementation with readmission and mortality outcomes in heart failure.” The authors were affiliated with well-known universities, and three of them were also editors of JAMA Cardiology [4]. Their research was financed by grants from the NIH and Get With the Guidelines-Heart Failure (GWTG-HF), a “voluntary quality improvement program” sponsored by the American Heart Association. Gupta et al. examined data on 30-day CHF readmission and mortality rates for the years 2006 to 2014 [5]. They divided this period into three segments – a pre-HRRP implementation phase (January 1, 2006 to March 31, 2010), the implementation phase (April 1, 2010 to September 30, 2012), and the HRRP penalty phase (October 1, 2012 to December 31, 2014). They found that 30-day readmissions fell during the penalty phase, while mortality rose slightly during the implementation phase and substantially during the penalty phase. The 30-day risk-adjusted mortality rate rose from 7.2 percent before HRRP implementation to 8.6 percent after. In an interview, co-author Gregg Fonarow stated, “If we were to extrapolate this to all Medicare beneficiaries hospitalized with heart failure, we are talking about maybe 10,000 patients a year with heart failure losing their liv...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Medicare Politics CMS Congress hospital readmissions HRRP Kip Sullivan MedPAC P4P Pay for Performance Source Type: blogs