One measure that is affected by CMS (Centers for Medicare & Medicaid Services) driven incentives and disincentives is hospital readmission rates. CMS established the Hospital Readmissions Reduction Program, which penalizes hospitals that have higher than expected 30-day readmissions rates, such as for heart attacks, heart failure and pneumonia. CMS offers incentives to hospitals who reduce readmissions through its Hospital Improvement and Innovation Networks.
Incentives and penalties have increased the focus of hospitals on readmissions. If readmission rates are higher than anticipated, they face financial penalties. In response, hospitals are implementing strategies to enhance patient care and decrease the risk of readmissions. This includes improving discharge plans, providing medication reconciliation and improving patient education and communications.
There are also concerns about the HRRP program, including that hospitals might avoid admitting patients in need of further treatment out of concern for financial penalties. This could lead to negative health outcomes. CMS, however, has said that this program was designed to help hospitals improve their quality of care by reducing readmissions and using evidence-based practice.
CMS-driven incentives and disincentives, have had an overall significant impact on the hospital readmission rate. They have also led to increased efforts and attention to improve transitions of patient care and reduce readmissions.