ArticleBMC health services research2019
Impact of the Medicare hospital readmissions reduction program on vulnerable populations.
Article in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 37 citations in OpenAlex.
- Early, unplanned readmission in diabetes inpatients: Comparing the utility and performance of machine learning and traditional prediction models to guide timely diabetes management team review.Diabetic medicine : a journal of the British Diabetic Association · 2026Article
- Assessing Patient Satisfaction With the Discharge Process Through a Patient-Centered Lens.Cureus · 2025Article
- Article
- Factors associated with unplanned readmissions for patients with mental and behavioural disorders in China: a quantitative analysis.Global health action · 2024Article
- Evaluating Quality of Care for Patients with Asthma in the Readmission Penalty Era.Annals of the American Thoracic Society · 2024Article
- Association of hospital and market characteristics with 30-day readmission rates from 2009 to 2015.SAGE open medicine · 2024Article
- Article
- The Politics of Population Health.The Milbank quarterly · 2023Article
- Accounting for the Growth of Observation Stays in the Assessment of Medicare's Hospital Readmissions Reduction Program.JAMA network open · 2022Article
- Hospital value-based payment programs and disparity in the United States: A review of current evidence and future perspectives.Frontiers in public health · 2022Review
- The effect of a mobile integrated health program on health care cost and utilization.Health services research · 2021Observational
- Evaluation of an intervention targeted with predictive analytics to prevent readmissions in an integrated health system: observational study.BMJ (Clinical research ed.) · 2021Observational
- Characteristics and Trends of the Hospital Standardized Readmission Ratios for Pneumonia: A Retrospective Observational Study Using Japanese Administrative Claims Data from 2010 to 2018.International journal of environmental research and public health · 2021Observational
- Examination of Post-discharge Follow-up Appointment Status and 30-Day Readmission.Journal of general internal medicine · 2021Article
- Readmissions and costs among younger and older adults for targeted conditions during the enactment of the hospital readmission reduction program.BMC health services research · 2021Article
- Potential of community-based risk estimates for improving hospital performance measures and discharge planning.BMJ open quality · 2021Article
- Association between Medicare's Hospital Readmission Reduction Program and readmission rates across hospitals by medicare bed share.BMC health services research · 2021Article
- Readmission Rates for Chronic Obstructive Pulmonary Disease Under the Hospital Readmissions Reduction Program: an Interrupted Time Series Analysis.Journal of general internal medicine · 2020Article
- Leveraging ensemble learning for predicting 30-day readmission in heart failure ICU patients.Digital healthArticle
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Hospital Readmissions Reduction Program (HRRP) was established by the 2010 Patient Protection and Affordable Care Act (ACA) in an effort to reduce excess hospital readmissions, lower health care costs, and improve patient safety and outcomes. Although studies have examined the policy's overall impacts and differences by hospital types, research is limited on its effects for different types of vulnerable populations. The aim of this study was to analyze the impact of the HRRP on readmissions for three targeted conditions (acute myocardial infarction, heart failure, and pneumonia) among four types of vulnerable populations, including low-income patients, patients served by hospitals that serve a high percentage of low-income or Medicaid patients, and high-risk patients at the highest quartile of the Elixhauser comorbidity index score.
methodsData on patient and hospital information came from the Nationwide Readmission Database (NRD), which contained all discharges from community hospitals in 27 states during 2010-2014. Using difference-in-difference (DD) models, linear probability regressions were conducted for the entire sample and sub-samples of patients and hospitals in order to isolate the effect of the HRRP on vulnerable populations. Multiple combinations of treatment and control groups and triple difference (DDD) methods were used for testing the robustness of the results. All models controlled for the patient and hospital characteristics.
resultsThere have been statistically significant reductions in readmission rates overall as well as for vulnerable populations, especially for acute myocardial infarction patients in hospitals serving the largest percentage of low-income patients and high-risk patients. There is also evidence of spillover effects for non-targeted conditions among Medicare patients compared to privately insured patients.
conclusionsThe HRRP appears to have created the right incentives for reducing readmissions not only overall but also for vulnerable populations, accruing societal benefits in addition to previously found reductions in costs. As the reduction in the rate of readmissions is not consistent across patient and hospital groups, there could be benefits to adjusting the policy according to the socioeconomic status of a hospital's patients and neighborhood.
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