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Higher Readmissions at Safety-Net Hospitals and Potential Policy Solutions

December 1, 2012

The Hospital Readmissions Reduction Program (HRRP), established by the Affordable Care Act, ties a hospital's payments to its readmission rates -- with penalties for hospitals that exceed a national benchmark -- to encourage hospitals to reduce avoidable readmissions. This new Commonwealth Fund analysis uses publicly reported 30-day hospital readmission rate data to examine whether safety-net hospitals are more likely to have higher readmission rates, compared with other hospitals. Results of this analysis find that safety-net hospitals are 30 percent more likely to have 30-day hospital readmission rates above the national average, compared with non-safety-net hospitals, and will therefore be disproportionately impacted by the HRRP. Policy solutions to help safety-net hospitals reduce their readmission rates include targeting quality improvement initiatives for safety-net hospitals; ensuring that broader delivery system improvements include safety-net hospitals and care delivery systems; and enhancing bundled payment rates to account for socioeconomic risk factors.

Achieving Better Quality of Care for Low-Income Populations: The Roles of Health Insurance and the Medical Home in Reducing Health Inequities

May 16, 2012

Outlines the importance of having both insurance and a medical home in reducing health and healthcare disparities for low-income adults, including access to care, preventive screenings, and satisfaction with quality of care. Makes policy recommendations.

Health Care Opinion Leaders' Views on Vulnerable Populations in the U.S. Health System

August 8, 2011

Presents survey responses from healthcare experts about the equity of the health system; healthcare reform's potential effects on safety-net institutions, access, and financial protection; and strategies for improving quality of care.

Organizing the U.S. Health Care Delivery System for High Performance

August 7, 2008

Analyzes the fragmentation of the healthcare delivery system and makes policy recommendations -- including payment reform, regulatory changes, and infrastructure -- for creating mechanisms to coordinate care across providers and settings.

Health Care Opinion Leaders' Views on Health Care Delivery System Reform

April 21, 2008

Presents findings of a survey of experts on reforming delivery systems -- organized delivery systems, patient-centered medical homes, and retail clinics -- and recommended policy strategies, such as improving the primary care system.

Health Care Opinion Leaders' Views on the Transparency of Health Care Quality and Price Information in the United States

December 16, 2007

Presents findings from a survey of experts on collecting and reporting public information on the quality and price of healthcare services; the role of transparency in improving quality, efficiency, and cost-effectiveness; and obstacles.

Bending the Curve: Options for Achieving Savings and Improving Value in Health Spending

December 1, 2007

Analyzes the potential of fifteen federal health policy options to lower spending over the next ten years and yield higher value on investments in health care.

Health Care Opinion Leaders' Views on the Quality and Safety of Health Care in the United States

July 30, 2007

Presents findings from an annual survey of a diverse group of experts on strategies to improve the quality and safety of health care in the United States.

Measuring Hospital Performance: The Importance of Process Measures

July 1, 2007

Evaluates the effectiveness of Hospital Quality Alliance standards, and identifies specific activities hospitals can work on to improve performance and deliver higher quality health care.