Hospital Readmissions Reduction Program

Section 3025 of the 2010 Affordable Care Act (Public Law 111-148) requires the Secretary of the Department of Health and Human Services (HHS) to establish the Hospital Readmissions Reduction Program (HRRP). Beginning with Fiscal Year (FY) 2013, the legislation mandates the Secretary reduce Inpatient Prospective Payment System (IPPS) payments to hospitals for excess readmissions on or after October 1, 2012.

The Hospital Readmissions Reduction Program (HRRP) is an important part of CMS’s continued efforts to link payment to the quality of hospital care. HRRP provides a strong financial incentive for hospitals that improve communication and care coordination efforts, and better engage patients and caregivers in post-discharge planning.

Fiscal Year 2018 Hospital Readmissions Reduction Program

The FY 2018 Hospital Readmissions Reduction Program calculates Excess Readmission Ratios (ERR) for six measures (i.e., AMI, HF, Pneumonia, COPD, CABG, and THA/TKA) to determine the payment adjustment factors for eligible hospitals. Hospitals can review their data to ensure CMS calculated the Excess Readmission Ratios correctly. Refer to the Review and Corrections page for more information on this process.

CMS releases hospitals’ Excess Readmission Ratios in the Inpatient Prospective Payment System/ Long-Term Care Hospital Prospective Payment System (IPPS/LTCH PPS) Final Rule, typically published in early August. CMS will report the Excess Readmission Ratios for the risk-standardized readmission measures for the Hospital Readmissions Reduction Program on Hospital Compare later this year.

For information on the of the payment adjustment factor calculations, refer to the Scoring Methodology or Payment Adjustment pages on QualityNet.

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