One measure that is affected by CMS (Centers for Medicare & Medicaid Services) driven incentives and disincentives is hospital readmission rates. CMS has established the Hospital Readmissions Reduction Program (HRRP), which imposes financial penalties on hospitals with higher-than-expected 30-day readmission rates for certain conditions such as heart attack, heart failure, and pneumonia. On the other hand, CMS also provides incentives for hospitals that reduce their readmission rates through the Hospital Improvement and Innovation Networks (HIINs).
These incentives and disincentives have led to increased focus on reducing hospital readmissions, as hospitals face financial penalties for higher-than-expected readmission rates. As a result, many hospitals have implemented strategies to improve patient care transitions and reduce the likelihood of readmissions, such as improving discharge planning, providing medication reconciliation, and enhancing patient education and communication.
The HRRP program has also led to concerns that hospitals may avoid readmitting patients who need further care out of fear of financial penalties, which may lead to adverse health outcomes for patients. However, CMS has stated that the program is designed to encourage hospitals to improve the quality of care and reduce readmissions through evidence-based practices.
Overall, CMS driven incentives and disincentives have had a significant impact on hospital readmission rates and have led to increased attention and efforts to improve patient care transitions and reduce readmissions.