Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Hospital Readmissions

Are Hospital Readmissions Reduction Program Results Overstated?

January 10, 2019 - CMS, researchers, and other healthcare stakeholders have touted the Hospital Readmissions Reduction Program (HRRP) touted as a success. Under the authority of the Affordable Care Act, CMS launched the HRRP in 2010 to incentivize hospitals to reduce hospital readmissions among Medicare beneficiaries. The pay-for-performance penalizes hospitals up to three percent of their reimbursement...

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Hospital Readmission Program Penalties Didn’t Raise Mortality Rates

by Jessica Kent

The Hospital Readmission Reduction Program (HRRP) achieved a significant drop in readmission rates for Medicare patients hospitalized for pneumonia, acute myocardial infarction (AMI), and heart failure without bringing an increase of...

Hospital Readmissions With Value-Based Penalties Vary by Provider

by Jacqueline LaPointe

Hospital readmission rates for conditions that carry value-based penalties under the Hospital Readmissions Reduction Program (HRRP) varied by admitting physician attending type, with geriatricians having the lowest 30-day readmissions...

3 Strategies to Reduce Hospital Readmission Rates, Costs

by Jacqueline LaPointe

Providers understand that high hospital readmission rates spell trouble for patient outcomes. But excessive rates may also threaten a hospital's financial health, especially in a value-based reimbursement...

Mortality Rates Rose After HRRP Value-Based Penalty Enforced

by Jacqueline LaPointe

Short and long-term mortality rates increased for Medicare beneficiaries hospitalized for heart failure after Medicare implemented the value-based penalty component of the Hospital Readmission Reduction Program (HRRP), a new JAMA...

Readmissions, Post-Acute Care Drive Variation in Bundled Payments

by Jacqueline LaPointe

Hospital readmissions, professional fees, and post-acute care payments are key drivers of cost variations for providers participating in 90-day cardiac bundled payment models, a recent JAMA Surgery study revealed. “These results...

Accountable Care Organization Saves $4.8M With Nutrition Aid

by Jacqueline LaPointe

A case study in American Health & Drug Benefits showed that Advocate Health Care, an accountable care organization in the Chicago area, reduced healthcare costs by $3,800 per patient, or $4.8 million in total, by implementing a...

Value-Based Penalties Target Hospitals With High Risk Patients

by Jacqueline LaPointe

Hospitals that serve greater volumes of African-American patients and those with more severe conditions are more likely to receive a value-based penalty under the Medicare Hospital Readmissions Reduction Program (HRRP), a new JAMA...

Should the Hospital Readmissions Reduction Program Add Sepsis?

by Jacqueline LaPointe

The Medicare Hospital Readmission Reduction Program currently determines value-based penalties on 30-day unplanned readmissions rates for six conditions. But the value-based reimbursement program may be missing a key condition that...

Are Medicare Value-Based Penalties Fair to Safety Net Hospitals?

by Jacqueline LaPointe

Safety-net hospitals have to work harder to avoid value-based penalties than other participants in a Medicare program designed to reduce hospital readmissions, a new study in Health Affairs indicates. While safety-net hospitals have made...

Preventable Readmissions Drop Under Value-Based Care Model

by Jacqueline LaPointe

Forty-nine states and Washington DC have decreased preventable hospital readmissions under a Medicare value-based care initiative that financially penalizes hospitals with excess readmissions, reported CMS. “The Hospital...

Value-Based Care Penalties Spark Greater Quality Improvements

by Jacqueline LaPointe

Financial penalties may be the key to advancing value-based care goals, such as reducing hospital admissions, according to a recent study in the American Journal of Managed Care. Almost two-thirds of hospital leaders stated that the...


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