A Comparative Evaluation of Medicare's Hospital Readmissions Reduction Program (HRRP) Effectiveness between New York State and the Nation
Author(s)
Aslam A, Fleishman J, Nayak R
St. John's University, Queens, NY, USA
OBJECTIVES: To compare and analyze the available HRRP 30-day inpatient readmissions data (2014-2019) longitudinally between NYS hospitals and the rest of the country and evaluate NYS hospital performance relative to six HRRP targeted health measures.
METHODS: We analyzed publicly available CMS Supplemental Data Files (2014-2017 & 2019) to examine the effect of HRRP on 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). We created (from the main sample) two subsets of hospital samples NYS & Non-NYS based on CMS Certification Number (CCN #33_ vs CCN≠ 33_). Excel data-analysis tools were used to compute and compare mean Excess Readmission Ratios (ERRs) for NYS hospitals and all other hospitals. Two sample two-tailed Welch’s t-tests (P>.05) were performed and plotted building confidence intervals around ERRs were constructed to track trends over time for each of the six targeted measures.
RESULTS: A total of 3173 hospitals nationwide were eligible to receive penalties in any of the reported fiscal years of supplemental data. A two-tailed Welch’s t-test (2014) indicated NYS (n1=145) performed worse than the national average (n2=3028) for COPD hospitalizations. NYS ranked lower than the national average for HF/PN/Total hospitalizations throughout 2014-2017 (p<.05]. Confidence intervals (95%) built around ERRs revealed that NYS performed significantly worse than the national average for AMI, COPD, HF, and PN in 2019 (P<.05).
CONCLUSIONS: NYS hospitals performed worse than all other hospitals on three of six health measures overall. For most recent fiscal year data (2019), NYS hospitals performed significantly below the national average with respect to four of six targeted conditions. Cumulatively, the analysis demonstrates current deficiencies within NYS hospital systems regarding Medicare cost control and may point to state-specific variables, hospital characteristics and patient socioeconomic factors.
Conference/Value in Health Info
Value in Health, Volume 26, Issue 6, S2 (June 2023)
Code
RWD148
Topic
Clinical Outcomes, Organizational Practices, Real World Data & Information Systems
Topic Subcategory
Comparative Effectiveness or Efficacy, Data Protection, Integrity, & Quality Assurance
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)