Prospect of Financial Penalty Appears To Reduce Hospital Readmission Rates: JAMA Study

Issue #553
AHRQ News Now is a weekly newsletter that highlights agency research and program activities.
February 7, 2017

AHRQ Stats: Patient-Provider Communication

From 2002 to 2013, the portion of uninsured adults who reported poor communication with health care providers dropped from 19 percent to 14 percent. (Source: Agency for Healthcare Research and Quality, 2015 National Healthcare Quality and Disparities Report Chartbook on Person- and Family-Centered Care.)

Today's Headlines:

Prospect of Financial Penalty Appears To Reduce Hospital Readmission Rates: JAMA Study

An AHRQ-funded study found that the prospect of financial penalties led hospitals to take steps that reduced patient readmissions. The study, published in December in JAMA, examined hospital readmission rates for heart attack, heart failure and pneumonia among Medicare fee-for-service beneficiaries before and after implementation of the Center for Medicare & Medicaid Services Hospital Readmission Reduction Program. The program, a part of the Affordable Care Act, started imposing financial penalties in October 2012 on hospitals with higher-than-expected readmissions. Before the program was announced, researchers found, readmission rates were mostly stable. After the program announcement in March 2010, however, hospitals subject to financial penalties reported significantly faster declines in readmissions than nonpenalized hospitals. Access the abstract.

AHRQ Seeks Organizations’ Input on Challenges and Solutions to Becoming Learning Health Care Systems

AHRQ has posted a Request for Information to gather feedback from health care organizations about current challenges and solutions to improving patient care by expanding and building on the use of evidence or becoming "learning health care systems." As defined by the National Academy of Medicine, learning health care systems are "designed to generate and apply the best evidence for the collaborative health care choices of each patient and provider; to drive the process of discovery as a natural outgrowth of patient care; and to ensure innovation, quality, safety, and value in health care." The deadline for submitting feedback is Feb. 28. AHRQ will use the information in future initiatives, such as developing research grant opportunities to advance this field, investing in the creation of tools and training materials for health professionals and health care delivery organizations, developing quality improvement measures, and/or convening collaboratives focused on accelerating the development of learning health care systems.

AHRQ Studies: Tonsillectomy Provides Some Benefit to Children With Throat Infections, Sleep-Disordered Breathing

Two articles recently published in Pediatrics found tonsillectomy to be of short-term benefit to children with recurrent throat infections or sleep-disordered breathing. The articles are based on an AHRQ-funded systematic review. In the first article, authors compared tonsillectomy with watchful waiting and found that throat infections and school absences declined in the year following surgery, as did the number of health care visits for sore throat and throat infections. In the first year post-surgical year, children who had tonsillectomies had an average 1.7 episodes of sore throat or throat infection compared with 2.9 episodes for those who did not undergo surgery. However, the benefits of surgery waned over time and information on long-term outcomes was limited. Access the abstract of the article. In the second article, authors found that among children with sleep-disordered breathing, those who had tonsillectomies had better sleep outcomes than those who engaged in watchful waiting. Researchers cautioned, however, that less is known about longer-term outcomes or treatment effects in specific subpopulations. Access the abstract of that article. Two additional articles on tonsillectomy based on the systematic review, one on postoperative bleeding, the other comparing full vs. partial tonsillectomy, were published in the journal Otolaryngology-Head and Neck Surgery.

AHRQ Report Shows Improvement in Patient-Provider Communications

A report from AHRQ shows the percentage of adults who reported poor communication with health providers decreased significantly for all ethnic groups between 2002 and 2013. Data in the Chartbook on Person- and Family-Centered Care indicate that Hispanic patients reported the largest improvement, while white patients and black patients reported more modest improvements. The chartbook also shows hospice patients age 65 and older were significantly more likely than patients ages 18 to 44 to receive care consistent with their stated end-of-life wishes. This chartbook and seven others are among documents and tools that support AHRQ’s National Healthcare Quality and Disparities Report and 5th Anniversary Update on the National Quality Strategy. The new chartbook is complemented by the National Quality Strategy’s Priorities in Focus: Person- and Family-Centered Care. AHRQ’s chartbooks are intended to identify strengths and weaknesses in different segments of health care systems. Other chartbook topics include Effective Treatment, Care Affordability, Care Coordination, Access, Healthy Living, Patient Safety and Health Care for Blacks.

New Research and Evidence From AHRQ

AHRQ in the Professional Literature

Impact of structured rounding tools on time allocation during multidisciplinary rounds: an observational study. Abraham J, Kannampallil TG, Patel VL, et al. JMIR Hum Factors 2016 Dec 9;3(2):e29. Access the abstract on PubMed®.

How physician perspectives on E-prescribing evolve over time. A case study following the transition between EHRs in an outpatient clinic. Abramson EL, Patel V, Pfoh ER, et al. Appl Clin Inform 2016 Oct 26;7(4):994-1006. Access the abstract on PubMed®.

Enhancing the evidence for behavioral counseling: a perspective from the Society of Behavioral Medicine. Alcántara C, Klesges LM, Resnicow K, et al. Am J Prev Med 2015 Sep;49(3 Suppl 2):S184-93. Access the abstract on PubMed®.

Morbid obesity and use of second generation antipsychotics among adolescents in foster care: evidence from Medicaid. Allaire BT, Raghavan R, Brown DS. Child Youth Serv Rev 2016 Aug;67:27-31. Epub 2016 May 30. Access the abstract on PubMed®.

Population well-being measures help explain geographic disparities in life expectancy at the county level. Arora A, Spatz E, Herrin J, et al. Health Aff 2016 Nov 1;35(11):2075-82. Access the abstract on PubMed®.

Telemedicine and primary care obesity management in rural areas—innovative approach for older adults? Batsis JA, Pletcher SN, Stahl JE. BMC Geriatr 2017 Jan 5;17(1):6. Access the abstract on PubMed®.

Now is the time to improve access and healthcare systems for childhood obesity treatment. Berkowitz RI, Daniels S. Obesity 2017 Jan;25(1):13-14. Epub 2016 Dec 7. Access the abstract on PubMed®.

Genome-wide gene-environment interaction analysis of pesticide exposure and risk of Parkinson's disease. Biernacka JM, Chung SJ, Armasu SM, et al. Parkinsonism Relat Disord 2016 Nov;32:25-30. Epub 2016 Aug 3. Access the abstract on PubMed®.

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Page last reviewed February 2017
Page originally created February 2017
Internet Citation: Prospect of Financial Penalty Appears To Reduce Hospital Readmission Rates: JAMA Study. Content last reviewed February 2017. Agency for Healthcare Research and Quality, Rockville, MD.