A new study raises the possibility that Medicare’s policy of penalizing hospitals that readmit patients within 30 days of their discharge may be flawed.

According to a new report in the Annals of Internal Medicine, risk factors for readmission often change within those 30 days.

In addition, patients with chronic medical problems are more likely to need readmission. Even the time of day of discharge appears to affect patients’ likelihood of readmission, with those discharged between 8 a.m. and 1:00 p.m. less likely to be readmitted.

The study also found that social determinants and insurance status also increase the likelihood of readmission within 30 days of discharge.

annals of internal medicineTogether, these and other findings appear to raise questions about the fairness of Medicare’s hospital readmissions reduction program.

These findings also mirror a growing body of research that suggests the program is inherently unfair to safety-net hospitals that serve large numbers of low-income patients who have had limited and sporadic access to medical care during their lives. NAUH has long pointed to the unfairness of this program and supported changes to improve it, most recently in a March letter to the House sponsors of H.R. 1343, the Establishing Beneficiary Equity in the Hospital Readmission Program Act, a bill that seeks to address those inequities.

To learn more, see this Fierce Healthcare report. Find the study “Differences Between Early and Late Readmissions Among Patients: A Cohort Study” here, on the web site of the Annals of Internal Medicine.