Does Public Reporting Change Readmission and Post-Discharge Care Trends?
No change occurred in 30-day readmission trends for myocardial infarction (MI), heart failure (HF) or pneumonia after the release of the Centers for Medicare and Medicine Services’ (CMS’) public reporting of hospital readmission rates in 2009, according to a study published Feb. 22 in the Journal of the American College of Cardiology.
Led by Adam D. DeVore, MD, a fellow in training at Duke Clinical Research Institute and Duke University School of Medicine, researchers analyzed readmissions and post-discharge care from Medicare claims data between 2006 – 2012 for patients discharged after hospitalization for MI (37,829 hospitalizations), HF (100,189) or pneumonia (79,076).
The results of the analysis show that while the release of CMS’ public reporting information was not associated with changes in 30-day readmission or post-discharge mortality trends, it was associated with “less hospital-based acute care for HF.”
DeVore et al., note that these results “have important policy implications and suggest that well-conducted trials of quality improvement interventions should be performed before widespread dissemination of these interventions.”
In an accompanying editorial comment, Martha J. Radford, MD, FACC, states that the authors’ analysis suggests an improvement in the “quality of care, particularly for chronic conditions.” She adds that “national health care reimbursement policy makers, including CMS and large payers, need to consider that there may be a limit to the extent to which acute-care readmission or post-discharge or hospital-based care rates can be decreased.”
Keywords: Centers for Medicare and Medicaid Services, U.S., Heart Failure, Hospitalization, Medicare, Myocardial Infarction, Patient Discharge, Patient Readmission, Pneumonia, Quality Improvement
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