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Member Research & Reports

Member Research & Reports

BU Finds Safety-net Hospitals Cut Readmissions, but Changes to Penalty Program Urged

Safety-net hospitals, which serve large populations of low-income patients, have made significant progress in reducing patient readmissions under a federal penalty program, but adjustments to the program should be considered, says a new study led by a Boston University School of Public Health (BUSPH) researcher.

The study, published online by Health Affairs, looked at the effects of Medicare’s Hospital Readmission Reduction Program (HRRP), which penalizes hospitals for high 30-day readmission rates for patients discharged for pneumonia, heart attack, and heart failure. Critics of the program have argued that the program disproportionately penalizes safety-net hospitals because they serve many low-income patients who lack post-hospitalization resources, such as primary care and social support, and have a higher probability of being readmitted.

The study, led by Dr. Kathleen Carey, BUSPH professor of health law, policy, and management, found that, in the first three years of the program, safety-net hospitals reduced readmissions for heart attacks by 2.86 percentage points, for heart failure by 2.78 percent, and for pneumonia by 1.77 percent. Those improvements, between 2013 and 2016, were greater than those achieved in other hospitals.

But the study also found that, when compared with other hospitals that had high readmission rates to begin with, safety-net hospitals had smaller reductions.

“This result may reflect the difficulties safety-net hospitals have in dealing with factors that influence readmission rates but are beyond the hospitals’ control, such as patient homelessness or lack of family support,” wrote Dr. Carey and her co-author, Ms. Meng-Yun Lin, a research data analyst at Boston Medical Center.

To read more about the study, go to: