OBJECTIVES: To analyze nationwide trends in hospitalization for six targeted CMS health measures under HRRP and evaluate the program’s success with respect to reduction of preventable readmissions.

METHODS: We analyzed publicly available CMS Supplemental Data Files (2014-2017 & 2019) to examine the effect of HRRP on 30-day inpatient hospital readmissions for the six reported health measures: Myocardial Infarction (AMI), Chronic Obstructive Pulmonary Disease (COPD), Heart Failure (HF), Pneumonia (PN), Coronary Artery Bypass Graft (CABG), and Total Hip Arthroplasty/Total Knee Arthroplasty (THA/TKA). Excel data-analysis tools were utilized to compute mean Excess Readmission Ratios (ERR) for peer-group hospitals and hospitals penalized by payment reduction, as well as track readmission trends over time for six conditions listed. Bivariate statistical analyses were performed to compare mean differences between hospital samples for ERR (95% CI) for each of the listed measures and with respect to known hospital characteristics.

RESULTS: Tracking trends for covered hospitals (n=3173) revealed two distinctive patterns in hospitalization rates over time for listed measures. A steep increase in hospitalization was observed for the period between 2014-2015 (2255.20 total net hospitalizations per year), followed by a period of gradual decrease (2015-2017; 355.96 total net hospitalizations per year). A set of 95% confidence intervals constructed for national ERR sample means for each of the outcome measures were statistically significant for AMI and COPD [P< .05].

CONCLUSIONS: The trend analysis reveals a rough “break in” period for HRRP but the program appears to achieve a steady and significant net reduction in hospitalizations for the six observed health measures over time. HRRP, during a 10-year period, has significantly reduced avoidable hospital readmissions but some targeted measures are more impacted than others. Observed variations in readmissions may be due to hospital characteristics, socioeconomic factors, program changes, modifications in payment methodologies etc., which also seem to affect program’s success over time.