Association of Coded Severity With Readmission Reduction After the Hospital Readmissions Reduction Program

Abstract

The Hospital Readmission Reduction Program (HRRP), established in 2010, placed significant financial penalties on hospitals with rates of readmission that were higher than expected for 3 targeted medical conditions.¹ Under the program, a hospital’s readmission rate is adjusted based on patients’ coded severity of illness. Although these adjustments reflect an effort from the Centers for Medicare & Medicaid Services to avoid unfairly penalizing hospitals caring for patients with higher severity of illness, hospitals can improve their calculated rates of readmission by increasing their coded level of severity. It is unknown whether changes in coded severity of illness explain the previously described reductions in readmissions after implementation of the HRRP.^1,2