Real Reason Hospital Readmissions Have Fallen

Harvard researcher says the overall decline in hospital admissions is a major factor
Robert Calandra

CMS credits the drop in hospital readmission rates to the Hospital Readmissions Reduction Program (HRRP). The 30-day readmission rate in 2009 was 17.5%; in 2014, it was 15.6%.

But researchers from Harvard Medical School say that the drop in readmissions may actually be the result of an overall decline in hospital admissions, according to a study published in this month in Health Affairs.

“Our study makes a strong case that what looked like achievements of the program may have been a byproduct of factors driving a broader decrease in hospitalizations across the board,” said J. Michael McWilliams, the study’s lead author and a Harvard Medical School professor, told Health Affairs.   

J. Michael McWilliams

The study by McWilliams and his colleagues was not an analysis of actual data but, rather, a computer simulation of readmission rates that was designed to tease out the readmissions that are caused by poor quality care. Those are the readmissions that the reductions program are designed to prevent. 

McWilliams says that the HRRP may have prevented some readmissions. But he does not think the program has been all that effective and remains skeptical of its value. 

“The best use of the findings is to take a step back and to really have a new conversation where we start thinking about way to improve quality that is not by linking incentives to performance measures, but just thinking about what interventions and strategies help improve quality,” McWilliams said in an interview with John Commins of HealthLeaders Media.