Hip, knee surgery readmission rates dip to underwhelming 5.5% under CMS penalties program

Written by Angie Stewart | July 02, 2019 | Print  |

CMS' penalties program didn't significantly cut down on readmissions after it was expanded to include surgical hip and knee replacements in 2013, according to a Health Affairs report.

CMS' Hospital Readmissions Reduction Program was launched in 2010 to penalize readmissions for patients with certain diagnoses. Health Affairs analyzed how risk-adjusted readmission rates, episode payments, lengths of stay, and observation status use changed after the 2013 expansion.

What you should know:

1. Risk-adjusted readmission rates for both procedures dropped from 7.6 percent in 2008 to 5.5 percent in 2016.

2. Readmission rates had already been declining before CMS unveiled the program in 2010, but the rate of reductions doubled afterward.

3. After hip and knee replacements were brought into the fold, readmission reductions slowed to the same rate as before any penalties were announced, indicating the additional penalties didn't have a significant effect.

4. From 2008 to 2016, analysts did observe substantial decreases in mean episode payments and lengths of stay. However, trends in observation status remained flat.

5. During the same time period, the average cost of a Medicare hip or knee replacement dropped by more than $3,000, EurekAlert! reports.

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