Accounting For Patients' Socioeconomic Status Does Not Change Hospital Readmission Rates

Abstract

There is an active public debate about whether patients'socioeconomic status should be included in the readmission measuresused to determine penalties in Medicare's Hospital ReadmissionsReduction Program (HRRP). Using the current Centers for Medicare andMedicaid Services methodology, we compared risk-standardizedreadmission rates for hospitals caring for high and low proportions ofpatients of low socioeconomic status (as defined by their Medicaid statusor neighborhood income). We then calculated risk-standardizedreadmission rates after additionally adjusting for patients' socioeconomicstatus. Our results demonstrate that hospitals caring for largeproportions of patients of low socioeconomic status have readmissionrates similar to those of other hospitals. Moreover, readmission ratescalculated with and without adjustment for patients' socioeconomicstatus are highly correlated. Readmission rates of hospitals caring forpatients of low socioeconomic status changed by approximately0.1 percent with adjustment for patients' socioeconomic status, and only3-4 percent fewer such hospitals reached the threshold for paymentpenalty in Medicare's HRRP. Overall, adjustment for socioeconomic statusdoes not change hospital results in meaningful ways.