Hospital Readmissions Reduction Program

E500470

Medicare value-based purchasing program U.S. federal health care program

The Hospital Readmissions Reduction Program is a U.S. Medicare value-based purchasing initiative that financially penalizes hospitals with excess patient readmissions in order to improve care quality and reduce avoidable hospitalizations.

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Statements (50)

Predicate	Object
instanceOf	Medicare value-based purchasing program ⓘ U.S. federal health care program ⓘ
adjustsFor	comorbidities ⓘ patient clinical risk factors ⓘ patient demographics ⓘ
administeredBy	Centers for Medicare & Medicaid Services NERFINISHED ⓘ U.S. Department of Health and Human Services NERFINISHED ⓘ
appliesTo	Medicare fee-for-service beneficiaries ⓘ acute care hospitals ⓘ
beneficiaryPopulation	older adults ⓘ people with disabilities covered by Medicare ⓘ
country	United States of America ⓘ surface form: United States
dataSource	Medicare claims data ⓘ
doesNotAdjustFor	socioeconomic status in original design ⓘ
excludes	cancer hospitals ⓘ children's hospitals ⓘ critical access hospitals ⓘ long-term care hospitals ⓘ psychiatric hospitals ⓘ rehabilitation hospitals ⓘ
financialMechanism	Medicare payment reduction ⓘ
implementedInFiscalYear	FY2013 ⓘ
laterIncorporated	peer grouping by proportion of dual-eligible patients ⓘ
legalBasis	Patient Protection and Affordable Care Act NERFINISHED ⓘ Section 3025 of the Affordable Care Act ⓘ
payer	Medicare NERFINISHED ⓘ
penalizes	hospitals with excess readmissions ⓘ
penaltyCap	3 percent of base operating DRG payments ⓘ
policyType	pay-for-performance ⓘ penalty-based incentive program ⓘ
purpose	improve quality of hospital care ⓘ reduce Medicare spending on preventable readmissions ⓘ reduce avoidable hospitalizations ⓘ reduce excess hospital readmissions ⓘ
relatedTo	Hospital Value-Based Purchasing Program NERFINISHED ⓘ Hospital-Acquired Condition Reduction Program NERFINISHED ⓘ
scope	Inpatient Prospective Payment System hospitals NERFINISHED ⓘ
sector	health care quality improvement ⓘ
startDate	2012-10-01 ⓘ
targetsCondition	acute myocardial infarction ⓘ chronic obstructive pulmonary disease ⓘ coronary artery bypass graft surgery ⓘ elective primary total hip arthroplasty ⓘ elective primary total knee arthroplasty ⓘ heart failure ⓘ pneumonia ⓘ
usesMetric	30-day hospital readmission rate ⓘ excess readmission ratio ⓘ hospital-wide readmission measure ⓘ risk-standardized readmission rate ⓘ

Referenced by (1)

Full triples — surface form annotated when it differs from this entity's canonical label.

Center for Clinical Standards and Quality → overseesProgram → Hospital Readmissions Reduction Program ⓘ