Researchers from the Department of Health and Human Services and Harvard Medical School compared 30-day readmission rates among Medicare beneficiaries from 2007-2015, using data from 3,387 hospitals. The authors found that during the eight-year time period, readmission rates for targeted conditions declined from 21.5% to 17.8%; rates for non-targeted conditions declined from 15.3% to 13.1%. Other key findings include:
- Readmission rates began to fall faster in April 2010, after the passage of the ACA
- Passage of the ACA was associated with a greater decline in readmissions for targeted conditions, rather than non targeted conditions
- In the long-term follow-up period, readmission rates continued to decline, but at a slower rate
“We found a change in the rate of readmissions coincident with the enactment of the ACA, which suggested that the Hospital Readmissions Reduction Program may have had a broad effect on care, especially for targeted conditions,” the researchers wrote.
The study also addresses some critics of HRRP, who suggest that hospitals keep returning patients in observation units, instead of readmitting them to the hospital, as a means to reduce readmission rates. While observation-unit use increased throughout the study period, the authors found no significant association within hospitals between increases in observation-unit use and reductions in readmissions.