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Getting Readmissions Penalties Right: Comparing Medicare and Medicaid Hospital Readmission Reduction Programs

Sharon Post
June 27, 2016
The Medicare Hospital Readmissions Reduction Program began four years ago, and has attracted both support for its overall efficacy and criticism for its impact on safety net hospitals.  Meanwhile, state Medicaid programs are using readmissions as a performance measure for hospitals and for managed care plans. This paper compares the federal HRRP with Illinois Medicaid’s Potentially Preventable Readmissions Program, and asks what Illinois can learn from the successes and shortcomings of the federal program. Sensitive to accusations of unfairness, we summarize some critiques of both programs and turn to our audience to ask what lies beyond readmissions penalties as we strive for a  health care delivery system that is more responsive to patients across the continuum of care. The Policy Brief can be downloaded here or viewed below.