Association of the Hospital Readmissions Reduction Program Implementation With Readmission and Mortality Outcomes in Heart Failure

The Hospital Readmissions Reduction Program (HRRP) was established as part of the Affordable Care Act in the US with the goal of adding an incentive for quality care that reduced hospital readmission rates. HRRP reduces Medicare reimbursement for hospitals with excess readmissions.

Gupta and colleagues sought to understand how this program affected outcomes for heart failure patients. The authors evaluated readmission for Medicare beneficiaries with heart failure from 2006 to 2014 using the American Heart Association’s Get With The Guidelines-Heart Failure registry and associated Medicare claims files. The authors found that the one-year risk-adjusted readmission rate decreased (HR 0.92) and the one-year risk-adjusted mortality rate increased (HR 1.10) following HRRP implementation. Secondary analysis that excluded patients who were discharged to hospice care found similar though attenuated changes.

The authors conclude that public health policies should be studied, as are drugs and devices, to ensure they confer the intended benefits.

The Wall Street Journal published an article highlighting this paper.