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July 18, 2017

Readmissions Have Declined, and Mortality Has Not Increased: The Importance of Evaluating Unintended Consequences

Author Affiliations
  • 1Brigham and Women’s Hospital, Boston, Massachusetts
  • 2Harvard T.H. Chan School of Public Health, Boston, Massachusetts
  • 3Washington University School of Medicine, St Louis, Missouri
  • 4Associate Editor, JAMA
JAMA. 2017;318(3):243-244. doi:10.1001/jama.2017.8705

In this issue of JAMA, Dharmarajan and colleagues1 evaluated whether the Hospital Readmissions Reduction Program (HRRP), which focuses on reducing 30-day hospital readmission rates, has been accompanied by changes in mortality rates. The HRRP is a mandatory national program that penalizes hospitals with higher-than-expected readmission rates based on the clinical risk of their patient population; in 2017, 79% of eligible hospitals were penalized, and the average penalty among penalized hospitals was 0.74% of Medicare inpatient payments.2 Congress created the HRRP to focus attention on the previously overlooked issue of readmission, a clinical outcome considered to represent unacceptable lapses in care and preventable spending.