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February 2, 2011

Hospital Readmission as an Accountability Measure

Author Affiliations

Author Affiliations: Center for Disease Prevention and Health Interventions for Diverse Populations, Ralph H. Johnson VAMC, and the Division of General Internal Medicine and Geriatrics, Medical University of South Carolina, Charleston (Dr Axon); and the Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Dr Williams).

JAMA. 2011;305(5):504-505. doi:10.1001/jama.2011.72

In June 2009, the Centers for Medicare & Medicaid Services (CMS) began publicly reporting on its Hospital Compare Web site all hospitals' 30-day readmission rates for patients hospitalized and discharged with pneumonia, acute myocardial infarction (AMI), or heart failure (HF). This “shaming” of some hospitals and research showing that about 1 in 5 Medicare patients is readmitted within 30 days after hospital discharge highlighted the problem of hospital care transitions.1 With passage of the Patient Protection and Affordable Care Act, CMS will begin holding hospitals accountable for their readmission rates and adjusting payments to hospitals in 2013 according to their rate of “excess” vs “expected” Medicare readmissions for pneumonia, AMI, and HF. Hospitals will now be subject to both the “shame” of public reporting and the likely more potent “stick” of decreased reimbursement. It is essential to consider these new policies in light of their likelihood of success and their potential for negative unintended effects as the health care industry attempts to address presumably elevated hospital readmission rates.

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