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.
In other words, FULL STEAM AHEAD FOR THE VALUE-BASED HEALTHCARE TRAIN! CHOO-CHOO!!
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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.