As 2,597 hospitals prepare to absorb financial penalties as a result of the Hospital Readmissions Reduction Program (HRRP), there is pressure from providers for “adjustments” to address socioeconomic disparities that many believe contribute to these penalties. Specifically, these hospitals would like to see a Senate version of the “Establishing Beneficiary Equity in the Hospital Readmission Program Act” to refine the HRRP calculations. However, the successful passing of this legislation is expected to be significantly influenced by a study on socioeconomic influences on readmissions by the U.S. Department of Health and Human Services. If the findings are similar to other studies on socioeconomic factors, the data may not give a decisive indication of the correlation between socioeconomic issues and readmissions as there many factors contributing to patient readmissions.
Here is one simple example of how the data related to socioeconomic factors does not clearly indicate the results you would expect. In the chart above, we compared the cities with lowest readmission rates (ranked 1 to 25 with 25 being the highest readmission penalty) against the same cities with their ranking of the % of residents that are 25 years and over that dropped out of high school. If the 2 factors had a close correlation, the two lines would be closely aligned. However, as the chart indicates, there are several instances where cities (such as Fort Worth and Houston) that have low readmission penalties, yet a high percentage of individuals that did not complete high school.
So, what actions do you take when the available data does not provide a clear indication of the impact that the socioeconomic conditions have on readmission rates? While the potential outcomes of the Senate are yet to be revealed, providers should consider pursuing their own primary research to determine the levels of need in the community they serve. This could be performed with a formal questionnaire for patients or simply tracking the count of conversations that your team holds with patients regarding financial assistance with medications or transportation expenses. Although tasking your frontline team with yet another responsibility is not a simple task, the validity of the data collected and measure by your team can reveal specific insights that may not be available with secondary research data. The data can then give your team the ability to make more informed decisions regarding internal actions to further reduce readmissions.