Aiming for Fewer Hospital U-turns: The Medicare Hospital Readmission Reduction Program
| Appendix Table: Variation in penalties by hospital type, 2013-2017 | |||||||||||||||||
| Hospital type | % of hospitals | % of Medicare patients | Average hospital payment adjustment | % of hospitals with any penalty | % of hospitals at max penalty | ||||||||||||
| 2013 | 2014 | 2015 | 2016 | 2017 | 2013 | 2014 | 2015 | 2016 | 2017 | 2013 (-1%) |
2014 (-2%) |
2015 (-3%) |
2016 (-3%) |
2017 (-3%) |
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| All | 100% | 100% | -0.27% | -0.25% | -0.49% | -0.48% | -0.58% | 64% | 66% | 78% | 78% | 79% | 8.0% | 0.6% | 1.2% | 1.1% | 1.8% |
| Rural/urban | |||||||||||||||||
| Urban | 75% | 89% | -0.26% | -0.23% | -0.46% | -0.46% | -0.57% | 65% | 66% | 78% | 79% | 80% | 7.1% | 0.1% | 0.8% | 0.9% | 1.5% |
| Rural | 25% | 11% | -0.30% | -0.31% | -0.57% | -0.51% | -0.64% | 62% | 65% | 79% | 77% | 77% | 11.5% | 1.9% | 2.2% | 1.7% | 2.7% |
| Teaching status | |||||||||||||||||
| Major teaching | 9% | 18% | -0.43% | -0.34% | -0.51% | -0.50% | -0.66% | 86% | 87% | 92% | 92% | 93% | 16.5% | 0.4% | 3.0% | 0.0% | 1.0% |
| Other teaching | 22% | 37% | -0.26% | -0.22% | -0.44% | -0.45% | -0.57% | 68% | 66% | 79% | 81% | 84% | 5.8% | 0.1% | 3.0% | 0.4% | 1.1% |
| nonteaching | 68% | 45% | -0.26% | -0.25% | -0.50% | -0.48% | -0.58% | 61% | 63% | 76% | 76% | 75% | 8.2% | 0.8% | 1.5% | 1.5% | 2.2% |
| Size | |||||||||||||||||
| <100 beds | 39% | 10% | -0.22% | -0.23% | -0.45% | -0.42% | -0.50% | 50% | 53% | 66% | 65% | 65% | 7.8% | 1.4% | 2.3% | 2.1% | 2.6% |
| 100-299 beds | 42% | 42% | -0.30% | -0.28% | -0.55% | -0.54% | -0.67% | 74% | 75% | 87% | 86% | 87% | 8.2% | 0.2% | 0.6% | 0.8% | 1.6% |
| 300+ beds | 20% | 49% | -0.31% | -0.25% | -0.43% | -0.45% | -0.57% | 71% | 73% | 85% | 87% | 90% | 9.5% | 0.0% | 0.2% | 0.0% | 0.6% |
| Proportion of patients who are low-income, Medicare | |||||||||||||||||
| Quartile 1 (Lowest) | 24% | 20% | -0.18% | -0.15% | -0.43% | -0.41% | -0.47% | 49% | 51% | 67% | 66% | 66% | 4.3% | 0.4% | 1.7% | 1.8% | 2.3% |
| Quartile 2 | 25% | 30% | -0.24% | -0.22% | -0.46% | -0.47% | -0.56% | 61% | 62% | 81% | 79% | 81% | 5.4% | 0.0% | 0.2% | 1.0% | 1.5% |
| Quartile 3 | 25% | 30% | -0.31% | -0.28% | -0.53% | -0.52% | -0.64% | 73% | 73% | 84% | 85% | 86% | 8.0% | 0.4% | 1.0% | 0.5% | 1.1% |
| Quartile 4 (Highest) | 25% | 20% | -0.37% | -0.36% | -0.54% | -0.52% | -0.69% | 77% | 78% | 84% | 85% | 86% | 14.7% | 1.3% | 1.8% | 1.4% | 2.5% |
| NOTES: The low-income Medicare patient proportion is derived from hospital ratios of Supplemental Security Income (SSI) patient days, with the 4th quartile having the highest ratio of low-income patient days. The percent of hospitals in each group is for 2016. The percent of patient admissions is from based on the March 2015 update of the FY 2014 MedPAR. Analysis excludes hospitals not subject to HRRP because they are not paid under the Medicare Hospital Inpatient Prospective Payment System (IPPS) (e.g., Maryland hospitals, psychiatric hospitals). SOURCE: Kaiser Family Foundation analysis of CMS Final Rules and Impact Files for the Hospital IPPS; CMS’s SSI calculations are from 2014 claims run out. |
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