Medicare’s Hospital Readmissions Reduction Program (HRRP) does not account for social risk factors in risk adjustment, and this may lead the program to unfairly penalize safety‐net hospitals. A study published in Health Services Research sought to determine the impact of adjusting for social risk factors on HRRP penalties. Researchers analyzed claims data for 2,952,605 fee‐for‐service Medicare beneficiaries with acute myocardial infarction (AMI), congestive heart failure (CHF) or pneumonia from December 2012 to November 2015. The study found poverty, disability, housing instability, residence in a disadvantaged neighborhood, and hospital population from a disadvantaged neighborhood were associated with higher readmission rates. The study concluded accounting for social risk can have a major financial impact on safety‐net hospitals. Adjustment for these factors could reduce negative unintended consequences of the HRRP.
- Adjusting for social risk factors impacts performance and penalties in the hospital readmissions reduction program. Volume 54, Issue 2, Health Services Research. April 2019