Rates of potentially preventable readmissions declined across all conditions between 2010 and 2014, according to a MedPAC analysis of Medicare claims data.
Congress enacted the Hospital Readmission Reduction Program in 2010, and in 2013 started levying penalties against hospitals that had above-average readmission rates for select conditions.
But preventable readmissions declined not just for those covered by the readmission reduction program. Across all conditions, the rates declined 1.9 percent, from 12.9 percent of discharges in 2010 to 11 percent in 2014.
The three conditions covered under the HRRP beginning in 2013 have experienced declines in potentially preventable readmission rates. The rates for acute myocardial infarction dipped three percentage points during the timeframe in question, while readmissions for heart failure declined 2.5 percent. Pneumonia readmissions shrank 1.6 percent over the same period.
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Chronic obstructive pulmonary disorder wasn't included in HRRP until 2015, but they declined 2.1 percent over the four-year period.
The analysis claims that these declines cannot be attributed primarily to an increase in observation stays. From 2011 to 2016, only 20 to 25 percent of the decline in readmissions can be accounted for by an increased use of outpatient observation, according to MedPAC.
The national readmission rate fell from 19 to 17.5 percent after penalties were put in place under HRRP, but the program has drawn criticism from the American Hospital Association. Last year, the AHA said the complexity of readmissions -- their varieties, causes and relation to factors outside of the hospital's control -- were a cause for concern. The group argued that not all readmissions can or should be prevented, while some are actually planned as a part of clinical care.
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The AHA also said that while the program's penalty formula includes readmissions unrelated to the patients' initial admission, its risk adjustment does not include key socioeconomic factors that research suggests have a significant impact on whether a Medicare beneficiary ends up back in the hospital.
In 2015, the nation's hospitals lost a combined $420 million in penalties, according to the Centers for Medicare and Medicaid Services.
Twitter: @JELagasse