The Society of Hospital Medicine (SHM) is supporting a Congressional push to tweak which admissions factors are taken into consideration in the federal Hospital Readmissions Reduction Program.
Hospitalist and SHM President Burke Kealey, MD, SFHM, says that the Establishing Beneficiary Equity in the Hospital Readmission Program Act (H.R. 4188) would help “level the playing field.”
Sponsored by U.S. Representative James Renacci (R-Ohio), the proposal seeks to “exclude from the program admissions related to transplants, end-stage renal disease, burns, trauma, psychosis, or substance abuse.” It also would require the U.S. Department of Health & Human Services (HHS) “in applying requirements for the excess readmission ratio to provide for a risk adjustment” that would take into account the percentage of inpatients eligible for both Medicare and Medicaid to avoid unfairly penalizing hospitals that treat the most vulnerable populations.
“We feel that some hospitals may be being unfairly handled in this program,” Dr. Kealey says. “Those are the hospitals that are having to deal with more complex populations or lower-SES [socioeconomic status] populations. Those are the hospitalists that actually need the most resources to help prevent readmissions, and they end up losing in this whole equation.”
In a letter to Rep. Renacci outlining SHM’s support for the bill, Dr. Kealey notes that the current readmissions reduction program “needs fine-tuning to better account for preventable readmission.”
Dr. Kealey also says he believes attempts by HHS to address readmissions are well-intentioned. However, as the program is implemented, he wants the government to be flexible in dealing with hospitals, particularly those dealing with complex populations or large groups of low-SES patients.
“We feel [these are] valuable programs, and in general, they help move the country in the right direction,” Dr. Kealey says. “But they certainly need to be open and available to be modified and changed to fit conditions better.”
SHM’s program to reduce hospital readmissions, Project BOOST, is accepting applications to its 2014 cohort through August 30. TH