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Comment & Response
March 24, 2021

Value of Discharging Heart Failure Patients Home—Reply

Author Affiliations
  • 1Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
  • 2Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
  • 3Cardiovascular Division, Department of Medicine, Washington University School of Medicine in St Louis, St Louis, Missouri
JAMA Cardiol. 2021;6(6):725-726. doi:10.1001/jamacardio.2021.0324

In Reply We thank Watson for his insightful comments. Although our study found no significant differences across inpatient quality measures for patients hospitalized with heart failure who were enrolled in either Medicare Advantage (MA) or fee-for-service (FFS) Medicare, MA patients were more likely to be discharged directly home.1

Watson raises an important point about whether the rate of clinically appropriate hospital discharges directly to home should be used as a quality metric. Such a measure is patient-centric and consistent with the fact that most chronically ill patients would prefer to spend more time in their own homes rather than in hospitals, skilled nursing facilities, or rehabilitative centers. We agree that quality metrics that incentivize health systems and clinicians to maximize patient’s time at home are worth investing in.

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