Unbiased Analysis of Today's Healthcare Issues
A commentary from Sheehy et al. (2023) argues that the hospital readmissions reduction program has been a disappointment. “If you can’t measure it, you can’t improve it”—a quote featured prominently on the Centers for Medicare & Medicaid Services (CMS) Measures Management website.3 But like any initiative intended to improve quality, evaluation, and iteration is key…
As the rates of COVID-19 increased the burden on hospitals in the early months of the pandemic, hospitals were decry a lack of beds and pressure on staff. While COVID-19 is of course a very acute case of over-crowding, a more general question is how much does hospital crowding impact health outcomes. A paper by…
A number of studies (e.g., Wasfy et al. 2017, Desai et al. 2016) have found that the Centers for Medicare and Medicaid Services (CMS) Hospital Readmissions Reduction Program (HRRP) reduce hospital readmissions. However, are these findings valid? A recent paper by Ody et al. (2019) argues maybe not. Because readmission rates are risk-adjusted, changing coding…
Maybe not. That is the answer from a study by Thompson et al. (2016). Using data from the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases (SID) for six states (AR, FL, IA, MA, NY,WA) from 2011 to 2013, the authors measure hospital performance reliability for the Hospital Readmission Reduction Program (HRRP). The define reliability as follows:…
In the past, Medicare basically paid hospitals the same amount for every type of admission regardless of quality. Of course, Medicare did adjust payments to hospitals based on the their cost of labor (hospital wage index adjustment), share of low-income patients (disproportionate share hospital payment), and number of medical school residents (indirect medical education payment),…
Currently, Medicare and private insurers are attempting to put in place incentives to reduce the number of readmissions. Visits to the hospital are costly and reducing the frequency of hospital visits is the best means to reduce medical costs. In particular, if readmissions are the fault of the care the patients receive during the initial…