SHM Converge Scientific Abstract ePoster Gallery-Identifying Hospitals With Highly Equitable Readmission Rates

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The document examines whether CMS equity measures for hospital readmissions overlap with traditional hospital performance metrics. Using a retrospective cohort of all U.S. non-Veterans Affairs hospitals eligible for the Hospital Wide Readmission measure (2018–2019 Medicare data), the study applied CMS “Disparity Methods” to identify hospitals with equitable 30-day readmission rates for two groups: Black vs. white patients and dual-eligible vs. non-dual-eligible patients.<br /><br />A hospital was considered equitable if it met three criteria: its risk-standardized readmission rate for the at-risk group was at or below the median across hospitals, the adjusted readmission rate difference between groups was within 1%, and it had at least 12 patients in the at-risk group.<br /><br />Among 4,767 hospitals, 1,967 (41%) treated at least 12 Black patients and 3,414 (72%) treated at least 12 dual-eligible patients. Of the eligible hospitals, 464 (23.6%) had equitable readmissions by race and 592 (17.3%) had equitable readmissions by insurance.<br /><br />The main finding is that equity in readmissions does not simply track with standard measures of hospital quality, cost, or value. Hospitals with equitable readmissions for Black patients were more likely to be high value and low cost, but not more likely to be high quality. Hospitals with equitable readmissions for dual-eligible patients were more likely to have low costs, but were associated with lower quality and were not associated with high value.<br /><br />Overall, the study concludes that traditional hospital accountability measures do not reliably capture equity. Therefore, equity-specific measures are needed to identify and evaluate hospitals providing more equitable care.

Asset Subtitle

Himali Weerahandi

Meta Tag

Author List Arjun Venkatesh, Himali Weerahandi, Huihui Yu, Jeph Herrin, Joseph S. Ross, Katherine A. Nash, Leora Horwitz, Louisa Holaday, Sunita Desai, Susannah M. Bernheim, Zhenqiu Lin

Category Research

Concept CMS Disparity Methods

Concept Readmission Rate

Concept Equity Measure

Concept Hospital Performance Metric

Concept Race

Distinguished Finalist

Presenter Organization Ucsf

Presenting Author Himali Weerahandi

Track Value in Hospital Medicine

Keywords

hospital readmissions

health equity

CMS disparity methods

risk-standardized readmission rate

Black patients

dual-eligible patients

hospital quality

hospital performance metrics

Medicare data

equitable care

CMS Disparity Methods

Readmission Rate

Equity Measure

Hospital Performance Metric

Race