Discuss the Medicare Hospital Readmissions Reduction Program (HRRP) which is a Medicare-executed federal policy initiative that penalizes hospitals for readmission rates that are greater than anticipated in an effort to reduce hospital readmissions for specific diseases.

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One of the policies that I would like to discuss is the Medicare Hospital Readmissions Reduction Program (HRRP) which is a Medicare-executed federal policy initiative that penalizes hospitals for readmission rates that are greater than anticipated in an effort to reduce hospital readmissions for specific diseases. According to CMS.GOV, “HRRP is a Medicare value-based purchasing program that, for example, encourages hospitals to improve communication and care coordination to better engage patients and caregivers in discharge plans and, in turn, reduce avoidable readmissions” (CMS.GOV, 2023). It involve patients and caregivers in discharge plans and, ultimately, lower avoidable readmission rates. By associating hospital treatment quality with payment, HRRP enhances the health care received by Americans.

Some of the ways in which criteria is used to measure includes: Lower Rates of Readmission: Reducing hospital readmission rates for specific illnesses (e.g., heart failure, pneumonia, acute myocardial infarction) within 30 days of release is one of the main objectives of HRRP. Measuring improvements in readmission rates among Medicare members treated at community hospitals would constitute community-level evaluation. To determine the overall impact of a program, state and federal studies which can calculate data from several communities.

Results for Health: Improvements in patient health outcomes linked to fewer readmissions, such as death rates, problems during follow-up hospital stays, and general post-discharge patient well-being, are used to assess an intervention’s effectiveness. Monitoring health outcomes among Medicare beneficiaries in the community is one aspect of community-level evaluation.

Obtaining Healthcare Services: Higher readmission rates may be caused by disparities in access to primary care and specialty care among other healthcare providers. It may be difficult for patients from underprivileged neighborhoods or remote locations to get prompt specialty consultations or follow-up care, both of which are essential for avoiding readmissions. resources.

Evaluation of the Hospital Readmissions Reduction Program (HRRP):

According to Sheehy et al. wherein they stated that readmission rates have not decreased as anticipated due to shortcomings in the measure itself, knowledge gained about the factors that lead to readmissions, and the quickly evolving US healthcare system. (2023, p. 549). People are not able to see the reduction of readmission rate particularly in seniors.

The effectiveness of the Hospital Readmissions Reduction Program (HRRP) is strongly impacted by social determinants of health (SDOH), which also affect readmission rates and the general efficacy of readmission reduction programs. They include:

Health Education and Literacy:

Lower health literacy patients may find it difficult to comprehend discharge instructions, to take their prescriiptions as prescribed, and to spot warning indicators of declining health after discharge. Higher readmission rates may result from a lack of knowledge about managing chronic illnesses.

Access to Healthcare Services: Higher readmission rates may be caused by disparities in access to primary care and specialty care among other healthcare providers. It may be difficult for patients from underprivileged neighborhoods or remote locations to get prompt specialty consultations or follow-up care, both of which are essential for avoiding readmissions.

Quality of Care: This is also important. This criterion covers patient safety protocols, following clinical recommendations, and patient-reported outcomes concerning hospital stays and care transfers.

For HRRP to be effective in lowering hospital readmissions, it is important that these socioeconomic determinants of health be addressed. Within the framework of HRRP activities, the policymakers and healthcare providers should take various aspects into account when developing and putting into practice plans to improve care transitions, increase patient education and support, and advance health equity.

References:

Centers for Medicare & Medicaid Services (2023). Hospital Readmissions Reduction Program (HRRP) Retrieved on 07TH July 2024 from

to an external site.

Rubin, D. J. (2018, March 13). Hospital readmission of patients with diabetes. PubMed. to an external site.

Yunwei Gai, & Dessislava Pachamanova. (2019). Impact of the Medicare hospital readmissions reduction program on vulnerable populations. BMC Health Services Research, 19(1), 1–15.

Sheehy, A. M., Locke, C. F. S., Bonk, N., Hirsch, R. L., & Powell, W. R. (2023, June 1). Health care policy that relies on poor measurement is ineffective: Lessons from the hospital readmissions reduction program. Health Services Research, 58(3), 549.

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