Hospital Readmission Success?

Quality metrics work! We cut hospital admissions! This came out in June:

The Commission found that the HRRP contributed to declines in readmissions but has not caused material increases in outpatient observation stays or emergency department visits, nor has the HRRP had a net adverse effect on mortality.  

Oh, wait. We just found out that the Hospital Readmissions Reduction Program success might have been overstated by more than half. Shucks. What was that line about statistics?

Another study shows a change in billing forms used by Medicare that was introduced during the same time frame accounts for more than half the reduction in risk-adjusted readmission rates that was previously attributed to the HRRP.

Once again this proves that quality metrics and “pay for performance” concepts suck. Here is what is said in the article quoted above:

Taken alongside the findings of another recent study suggesting some of the program’s unintended consequences may actually cause harm to patients, the data to date highlight the difficulties confronting policymakers as they design and test the programs designed to drive the shift toward a value-based healthcare system.


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Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  1 comment for “Hospital Readmission Success?

  1. Steve
    January 9, 2019 at 1:57 pm

    Back just before this was implemented and hospitals began to prep physician staff to support the efforts, there was a push: See your patients early after discharge (most groups seem to have ignored this) and do your best to keep these patients out of the hospital in that 30 day period. The ER was part of the group getting prepped.

    Many of us, knowing that so many factors causing readmission are totally out of the control of doctors, predicted an increase in mortality rates as everyone did their best to prevent readmission for the key groups.

    Hmmm….. Looks like we were right.

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