Readmission rates in not-for-profit vs. proprietary hospitals before and after the hospital readmission reduction program implementation

• Published in: BMC health services research Vol. 18; no. 1; pp. 31 - 7
• Main Authors: Birmingham, Lauren E., Oglesby, Willie H.
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 19.01.2018; BioMed Central; BMC
• Subjects: Ambulatory care facilities; Analysis; Chief executive officers; Clinical outcomes; Data analysis; Forecasts and trends; Health care policy; Health policy; Health services; Healthcare quality; Hospital; Hospital costs; Hospitalization; Human subjects; Medicaid; Medical care quality; Medicare; Mortality; Nonprofit hospitals; Not-for-profit hospital; Patient care; Patient Protection & Affordable Care Act 2010-US; Patient satisfaction; Patients; Proprietary; Proprietary hospital; Quality; Readmissions; Regression analysis; Review boards; Services; Socioeconomic factors; Statistical analysis; United States > US; Proprietary hospital; Not-for-profit hospital; Health policy; Hospital; Healthcare quality; Readmissions
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-018-2840-4

The Patient Protection and Affordable Care Act established the Hospital Readmission Reduction Program (HRRP) to penalize hospitals with excessive 30-day hospital readmissions of Medicare enrollees for specific conditions. This policy was aimed at increasing the quality of care delivered to patients and decreasing the amount of money paid for potentially preventable hospital readmissions. While it has been established that the number of 30-day hospital readmissions decreased after program implementation, it is unknown whether this effect occurred equally between not-for-profit and proprietary hospitals. The aim of this study was to determine whether or not the HRRP decreased readmission rates equally between not-for-profit and proprietary hospitals between 2010 and 2012. Data on readmissions came from the Dartmouth Atlas and hospital ownership data came from the Centers for Medicare and Medicaid Services. Data were joined using the Medicare provider number. Using a difference-in-differences approach, bivariate and regression analyses were conducted to compare readmission rates between not-for-profit and proprietary hospitals between 2010 and 2012 and were adjusted for hospital characteristics. In 2010, prior to program implementation, unadjusted readmission rates for proprietary and not-for-profit hospitals were 16.16% and 15.78%, respectively. In 2012, following program implementation, 30-day readmission rates dropped to 15.76% and 15.29% for proprietary and not-for-profit hospitals. The data suggest that the implementation of the Hospital Readmission Reduction Program had similar effects on not-for-profit and proprietary hospitals with respect to readmission rates, even after adjusting for confounders. Although not-for-profit hospitals had lower 30-day readmission rates than proprietary hospitals in both 2010 and 2012, they both decreased after the implementation of the HRRP and the decreases were not statistically significantly different. Thus, this study suggests that the Hospital Readmission Reduction Program was equally effective in reducing readmission rates, despite ownership status.