Financial penalties are successful at reducing the amount of readmissions at hospitals, according to a new study conducted by Yale School of Medicine. Hospitals that were penalized were more likely to reduce readmissions for all conditions compared to those that weren’t penalized.

The Hospital Readmission Reductions Program, which was enacted as part of the ACA, began imposing financial penalties in October 2012 on hospitals with high readmission rates for acute myocardial infarction, congestive heart failure and pneumonia. Since then, thousands of hospitals have accumulated almost $1 billion in penalties.

As part of the study, the researchers evaluated data from Medicare fee-for-service beneficiaries over age 64 who were discharged between January 1, 2008 and June 30, 2015 from 2,214 penalty hospitals and 1,283 non-penalty hospitals.

In January 2008, the mean readmission rates for AMI, HF, pneumonia and non-target conditions at hospitals subject to financial penalties were 21.9 percent, 27.5 percent, 20.1 percent and 18.4 percent, respectively and 18.7 percent, 24.2 percent, 17.4 percent and 15.7 percent at non-penalty hospitals.

Before the HRRP announcement, readmission rates were stable across hospitals except for AMI at non-penalty hospitals. However, after the announcement readmission rates for all conditions declined much faster for patients at penalty hospitals than non-penalty.

The hospitals seem to have responded to the external policy initiatives, but the researchers noted that readmissions reductions have plateaued since then.

"We know that not all readmissions are preventable, but we are also looking for ways to improve readmission numbers even further," Dr. Nihar R. Desai, assistant professor of medicine at Yale School of Medicine, said in a statement. "We're exploring whether additional reductions in readmissions are attainable and feasible and what kind of policy environment would be needed to foster those additional reductions."

Cardiology Homepage