COMPARING ATTITUDES AND OUTCOMES OF THE AFFORDABLE CARE ACT'S READMISSION REDUCTION PROGRAM IN TEXAS RURAL AND URBAN HOSPITALS

Purpose (a): Section 3025 of the Affordable Care Act, The Readmission Reduction Program, which outlines penalties to participating hospitals with high readmission rates in certain diagnoses, began the Federal fiscal year (FY) of 2012 and has been met with mixed criticism as to its fairness as well as its results. Penalties asserted to participating hospitals under this policy will rise from 1% of Medicare reimbursement dollars (FY 2012) to eventually 3% (FY 2015) with limited data suggesting improved quality of care as a result of implementation. Prior data is conflicting if readmission rates are a positive, negative, or even contributory to outcomes on the national scale. This project sought to determine if readmission rates had gone down in participating Texas hospitals and what the attitudes are at hospitals concerning the readmission rate as a measure of quality of care. Furthermore, we sought to review possible discrepancies between rural and urban facilities. Methods (b): Hospitals were approached among a qualifying list with the intent of gathering a sample size of 25. A cross-sectional survey was provided to participating hospitals inquiring about the following: readmission rates as a factor for quality of care, protocol for discharge instructions, average length of stay increases, penalties assessed by Medicare, and Medicare reimbursements as significant income (25%) to the hospital. Results (c): Preliminary data is being gathered and indicates that while attitudes remain ambiguous an increased focused on readmission rates have driven readmission down. Readmission rate as a factor of quality of care remains undetermined.