Although evidence exists to support the argument that safety-net hospitals face a greater challenge relative to other hospitals in the Hospital Readmissions Reduction Program (HRRP), an analysis in the October issue of Health Affairs shows they reduced readmissions for the program’s three initial target conditions, and they have reduced the disparity between their readmission rates and those of other hospitals.

Researchers analyzed 30-day readmission rates for acute myocardial infarction (AMI), heart failure and pneumonia for fiscal years 2013 and 2016. The risk-adjusted readmission rates for all three health conditions were significantly higher for safety-net hospitals relative to other hospitals in the overall sample for both years, but the differences in rates between the safety-net hospitals and other hospitals declined from 2013 to 2016. 

Specifically, from 2013 to 2016, readmission rates among the safety-net hospitals fell 2.86 percentage points for AMI, 2.78 percentage points for heart failure and 1.77 percentage points for pneumonia—all greater reductions than those for other hospitals, overall. 

Nonetheless, the researchers pointed out that safety-net hospitals have not improved as much as other hospitals with initially high readmission rates (i.e., those with just as much room for improvement) and said they support MedPAC’s recommendation for modifying the penalties imposed on safety-net hospitals: evaluate them against other safety-net hospitals.

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