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Affordable Care Act (ACA) financial penalties intended to discourage repeat hospitalizations are associated with higher mortality rates for patients with heart failure, according to a recent study.
The Hospital Readmissions Reduction Program (HRRP) penalizes hospitals with high rates of readmissions within 30 days of discharge for Medicare patients with heart failure, pneumonia, and heart attacks, and the research suggests that this strategy has been effective in one sense.
Data on 115,245 heart failure patients hospitalized from 2006 to 2014 indicated that readmission rates dropped from 20% before the ACA penalties took effect to 18.4% after.
However, that was not necessarily good for patients.
The proportion of patients who died within 30 days of going home increased from 7.2% to 8.6% in the same period.
Further, one-year mortality rates climbed from 31.3% to 36.3%, researchers from the David Geffen School of Medicine at the University of California, Los Angeles reported.
The researchers looked at three distinct time periods: before the ACA, from Jan. 1, 2006, to March 31, 2010; during an ACA implementation period from April 1, 2010, to Sept. 30, 2012; and after readmission penalties kicked in, from Oct.1, 2012, to Dec. 31, 2014.
“Among fee-for-service Medicare beneficiaries discharged after heart failure hospitalizations, implementation of the HRRP was temporally associated with a reduction in 30-day and one-year readmissions, but an increase in 30-day and one-year mortality,” the researchers concluded. “If confirmed, this finding may require reconsideration of the HRRP in heart failure.”
An abstract of the study is available online at: http://bit.ly/2AJqmRR.