AHA Fact Sheet: Hospital Readmissions Reduction Program

The Issue

The Affordable Care Act (ACA) required the Centers for Medicare & Medicaid Services (CMS) to penalize hospitals for “excess” readmissions when compared to “expected” levels of readmissions. Since the start of the program on Oct. 1, 2012, hospitals have experienced nearly $1.9 billion of penalties, including $528 million in fiscal year (FY) 2017.

In FY 2013, payment penalties were based on hospital readmissions rates within 30 days for heart attack, heart failure and pneumonia. In FY 2015, CMS added readmissions for patients undergoing elective hip or knee replacement and patients with chronic obstructive pulmonary disease. CMS will add readmissions for coronary artery bypass procedures in FY 2017 and likely will add other measures in the future.

Related Resources

Special Bulletin
Public
The Centers for Medicare…
Advisory
The AHA Board of Trustees today approved a policy statement that strongly urges the vaccination of all health care personnel. The AHA also supports hospitals…
Special Bulletin
Public
Download the AHA Special Bulletin: CMS Issues Hospital Outpatient/ASC Proposed Rule, Including Modifications to Price Transparency Rule
Special Bulletin
Public
The Centers for Medicare…
Letter/Comment
Public
the AHA and American Medical Association urge CMS to delay advanced imaging appropriate use timeline.
AHA Center for Health Innovation Market Scan
Anthem and Epic are collaborating to expand bidirectional data exchange. The partnership will integrate Epic’s payer platform into Anthem’s operating system…