ArticleHealth services research2019
Adjusting for social risk factors impacts performance and penalties in the hospital readmissions reduction program.
Article in Health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 105 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
105 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Impact of social determinants of health on perioperative and interstage outcomes in congenital heart surgery a systematic review.Frontiers in cardiovascular medicine · 2026Pooled it
- Area-Level Socioeconomic Disadvantage and Health Care Spending: A Systematic Review.JAMA network open · 2024Pooled it
- Influence of Social Determinants of Health on Heart Failure Outcomes: A Systematic Review.Journal of the American Heart Association · 2023Pooled it
- Risk Factors for Early Hospital Readmission in Geriatric Patients: A Systematic Review.International journal of environmental research and public health · 2023Pooled it
- Social Risk Adjustment In The Hospital Readmissions Reduction Program: A Systematic Review And Implications For Policy.Health affairs (Project Hope) · 2022Pooled it
- Patient and hospital factors associated with 30-day readmissions after coronary artery bypass graft (CABG) surgery: a systematic review and meta-analysis.Journal of cardiothoracic surgery · 2021Pooled it
- Greater Covid-19 vaccine uptake among enrollees offered health and social needs case management: Results from a randomized trial.Health services research · 2024Trial
- Longitudinal trajectories of hospitalizations in US older adults with heart failure.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026Article
- Article
- Article
- Measuring What Matters: Days Alive and Out of Hospital and Health Care Utilization in Kidney Transplantation.Kidney360 · 2026Article
- Baseline risk factors associated with all-cause early hospitalization of older patients following admission to Danish municipal temporary stays.BMC health services research · 2026Article
- Hospital Readmission Reduction Program Penalties for Hospitals With High Medicare Advantage Penetration.JAMA network open · 2026Article
- Exploring the cost-effectiveness and optimization strategies of nursing caring for children and older adults: a perspective.Frontiers in public health · 2026Article
- Demographic disparities in heart failure with preserved ejection fraction.Heart failure reviews · 2025Review
- Impact of the Swedish Care Coordination Act on Heart Failure Readmissions and Length of Stay.Circulation. Heart failure · 2025Article
- Factors Associated with Documenting Social Determinants of Health in Electronic Health Records.Journal of the American Board of Family Medicine : JABFM · 2025Article
- One cutoff is not enough: Assessing different area deprivation index cutoffs for insurance types on surgical Desirability of Outcome Ranking (DOOR).Healthcare (Amsterdam, Netherlands) · 2025Article
- The application of neighborhood area deprivation index to improve health equity across the spectrum of heart failure: a review.Heart failure reviews · 2025Review
- Opportunities in stroke care at safety net hospitals: A socioecological perspective.Equity neuroscience · 2025Article
45 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
objectiveMedicare's Hospital Readmissions Reduction Program (HRRP) does not account for social risk factors in risk adjustment, and this may lead the program to unfairly penalize safety-net hospitals. Our objective was to determine the impact of adjusting for social risk factors on HRRP penalties. STUDY
designRetrospective cohort study. DATA SOURCES/STUDY
settingClaims data for 2 952 605 fee-for-service Medicare beneficiaries with acute myocardial infarction (AMI), congestive heart failure (CHF) or pneumonia from December 2012 to November 2015. PRINCIPAL
findingsPoverty, disability, housing instability, residence in a disadvantaged neighborhood, and hospital population from a disadvantaged neighborhood were associated with higher readmission rates. Under current program specifications, safety-net hospitals had higher readmission ratios (AMI, 1.020 vs 0.986 for the most affluent hospitals; pneumonia, 1.031 vs 0.984; and CHF, 1.037 vs 0.977). Adding social factors to risk adjustment cut these differences in half. Over half the safety-net hospitals saw their penalty decline; 4-7.5 percent went from having a penalty to having no penalty. These changes translated into a $17 million reduction in penalties to safety-net hospitals.
conclusionsAccounting for social risk can have a major financial impact on safety-net hospitals. Adjustment for these factors could reduce negative unintended consequences of the HRRP.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.