Penalizing hospitals for chronic obstructive pulmonary disease readmissions.

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Penalizing hospitals for chronic obstructive pulmonary disease readmissions.

Am J Respir Crit Care Med. 2014 Jan 24;

Authors: Feemster LC, Au DH

In October 2014, the United States Centers for Medicare & Medicaid Services (CMS) will expand its Hospital Readmission Reduction Program (HRRP) to include Chronic Obstructive Pulmonary Disease (COPD). Under the new policy, hospitals with high risk-adjusted, 30-day all-cause unplanned readmission rates after an index hospitalization for a COPD exacerbation will be penalized with reduced reimbursement for the treatment of Medicare beneficiaries. In this perspective, we review the history of the HRRP, including the recent addition of COPD to the policy. We critically assess the use of 30-day all-cause COPD readmissions as an accountability measure, discussing potential benefits and then highlighting the substantial drawbacks and potential unintended consequences of the measure that could adversely affect providers, hospitals and patients with COPD. We conclude by emphasizing the need to place the 30-day COPD readmission measure in the context of a re-conceived model for post-discharge quality and review several frameworks that could help guide this process.

PMID: 24460431 [PubMed - as supplied by publisher]

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