While a substantial body of research has studied HRRP mostly for its impact on quality outcomes (such as 30-day readmission rates), 13, 14 the prior literature has not comprehensively studied the impact of HRRP on inter-dependent dimensions of health care performance (such as cost and patient experience). 11 Since achieving the Triple Aim objectives may require hospitals to make significant tradeoffs, we investigate whether the HRRP had a significant impact on all 3 measures-healthcare quality, cost, and patient experience-simultaneously. The HRRP has been criticized for only incentivizing hospitals to reduce readmission rates at all costs, but not for having mechanisms to enforce improvements in other important areas of healthcare delivery, such as patient safety and experience. In this study, we analyze whether the HRRP achieved its intended Triple Aim goals, with respect to improvements in patient quality of care, reductions in cost, and improvements in patient experience, since it is important for policymakers to pursue synergies across these inter-dependent objectives. 10ĭespite substantial efforts to reduce hospital readmission rates, the impact of the HRRP on the Triple Aim has not been studied in a unified manner. 4 Prior research has used the Triple Aim to evaluate interventions that support development and use of patient self-management programs, 5, 6 mental health treatment programs, 7 care transitions, 8 accountable care organizations, 9 and telehealth. The Triple Aim initiative was introduced by the Institute for Healthcare Improvement, building upon 3 interdependent pillars of healthcare: quality of population health, cost of care, and individual experience of care. In this study, we evaluate the efficacy of HRRP based on its impact on the Triple Aim goals. 2 Considering that hospitals typically operate on an average gross margin of 5-7%, the financial penalty imposed by the HRRP policy is substantial. In 2019 alone, 2,583 hospitals were penalized for a total amount of $566 Million. CMS increased this penalty up to 2% in 2014, and up to 3% from 2015 onward. hospitals were penalized by 1% of overall Medicare reimbursements. Initially, the program covered heart attack, congestive heart failure (CHF), and pneumonia, but was soon expanded to include other chronic conditions, such as chronic obstructive pulmonary disorder (COPD). 1 The HRRP mandates CMS to reduce payments to hospitals with excessive readmission rates. The Centers for Medicare and Medicaid Services (CMS) established the Hospital Readmission Reduction Program (HRRP) in 2012, under Section 3025 of the Affordable Care Act (ACA), with a focus on reducing excessive hospital readmissions.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |