Hospital Readmissions Reduction Program (HRRP) Archives

Archived Supplemental Data Files

Refer to the Archived Supplemental Data Files   page on CMS.gov for the supplemental data released with the Inpatient Prospective Payment System (IPPS) final rule each fiscal year (FY).

Archived Finalized Policies

In the FY 2019 IPPS final rule, the Centers for Medicare & Medicaid Service (CMS) finalized the following policy:

  • Codified previously finalized definitions of dual-eligible patients, dual proportion, and the applicable period for dual-eligibility.
  • Reviewed HRRP’s measures to align with the Meaningful Measures Framework and deduplicate measures across programs. Beginning with FY 2020, the six HRRP readmission measures will be removed from the Hospital Inpatient Quality Reporting (IQR) Program.

In the FY 2018 IPPS final rule, CMS finalized the following policy:

  • Changed the methodology to calculate the payment adjustment factor in accordance with the 21st Century Cures Act to assess a hospital’s performance relative to other hospitals with a similar proportion of patients who are dually eligible for Medicare and full-benefit Medicaid beginning with the FY 2019 program.
  • Updated the Extraordinary Circumstances Exemption (ECE) policy to allow hospitals to submit a form signed by the hospital’s Chief Executive Officer or designated personnel and to allow CMS to grant ECEs due to CMS data system issues which affect data submission.

In the FY 2017 IPPS final rule, CMS finalized the following policy:

  • Revised the date for publicly reporting hospitals’ excess readmission ratio on the Hospital Compare website to allow CMS to post data as soon as possible following the review period. 

In the FY 2016 IPPS final rule, CMS finalized the following policies:

  • Adopted an ECE policy allowing hospitals that experience a significant disaster or other extraordinary circumstance beyond the hospital’s control (e.g. hurricane, flood) to request an exemption.
  • Refined the pneumonia readmission measure by expanding the measure cohort to include additional pneumonia diagnoses: (i) patients with aspiration pneumonia; and (ii) sepsis patients coded with pneumonia present on admission, excluding severe sepsis, beginning with the FY 2017 program.

In the FY 2015 IPPS final rule, CMS finalized the following policies:

  • Expanded the applicable conditions beginning with the FY 2017 program to include patients admitted for coronary artery bypass graft (CABG) surgery.

In the FY 2014 IPPS final rule, CMS finalized the following policies:

  • Applied an algorithm to account for planned readmissions to the readmissions measures.
  • Expanded the applicable conditions beginning with the FY 2015 program to include: (1) patients admitted for an acute exacerbation of chronic obstructive pulmonary disease (COPD); and (2) patients admitted for elective primary total hip arthroplasty (THA) and/or total knee arthroplasty (TKA).

In the FY 2013 IPPS final rule, CMS finalized the following policies:

  • Defined the hospitals subject to HRRP.
  • Established the methodology to calculate the payment adjustment factor.
  • Established the process for hospitals to review their readmission information and submit corrections before the excess readmission ratios are public.

In the FY 2012 IPPS final rule, CMS finalized the following policies:

  • Defined readmission as an admission to a subsection (d) hospital within 30 days of a discharge from the same or another subsection (d) hospital;
  • Adopted readmission measures for the applicable conditions of acute myocardial infarction (AMI), heart failure (HF), and pneumonia;
  • Established a methodology to calculate the excess readmission ratio for each applicable condition, which uses a risk adjustment methodology endorsed by the National Quality Forum (NQF).
  • Established an applicable period of three years of discharge data and a minimum of 25 discharges for applicable conditions to be eligible to contribute to the payment adjustment.

For more information on these policies, please refer to the IPPS Regulations and Notices in the Related Links section of the Hospital Readmissions Reduction Program Home Page.

 

Page Last Modified:
07/31/2019 12:37 PM