The Association Between Structural, Performance, and Community Factors and the Likelihood of Receiving a Penalty Under the Hospital Readmissions Reduction Program (Fiscal Year 2013–2019)

Bibliographic Data

ID19578648
AuthorsJason N Mose (East Carolina University, corresponding author), Neela K Kumar, Neela Kumar (University of North Carolina at Chapel Hill)
Year2020
Volume4
Issue1
Pages129-138
Publication date2020-04-01
Open AccessYes
TypeARTICLE
VenueHealth Equity (JOURNAL)
Journal identifiersISSN: 2473-1242 • E-ISSN: 2473-1242
PublisherSAGE Publications (PUBLISHER • US)
DOI10.1089/heq.2019.0123
PMID32368711
OpenAlexW3020274316
LanguageEN
References cited33

Purpose: Little is known about the role of structural, performance, and community factors that impact the likelihood of receiving a penalty under the Hospital Readmission Reduction Program. This study examined the association between structural, performance, and community factors and the likelihood of receiving a penalty as well as investigated the likelihood of hospitals serving vulnerable populations of receiving a penalty. Methods: Centers for Medicare and Medicaid Services and United States Census Bureau data were used in this analysis. Ordered logistic regressions in a cross-sectional analysis were employed to estimate the probability of receiving a high or low penalty in the fiscal year 2013 through 2019. Results: On average, medium-sized, major teaching, and safety-net hospitals had the highest proportion of hospitals with a high penalty. After controlling for performance and community factors, structural factor variables such as safety-net status, rural status, and teaching status either were no longer significant or the likelihood magnitude changed. However, after controlling for performance and community factors, the statistical significance of hospital size variables and geographic location persisted across the years. Length of stay and occupancy rate variables were also statistically significant across the 7 years under review. Conclusion: Taken together, structural, performance, and community factors are important in explaining variation in the likelihood of receiving a penalty. There is no evidence that safety-net, rural, and public hospitals are more likely to receive a penalty. The results also suggest that there is room for providers to reduce avoidable readmissions and policymakers to mitigate unintended consequences

American Community Survey · Business · Census · Economics · Environmental health · Fiscal year · Health care · Logistic regression · Medicaid · Demography · Emergency and Acute Care Studies · Healthcare Policy and Management · Hospital Admissions and Outcomes · Medicine · Finance · Internal Medicine

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