Health Equity and Hospital Readmissions: Does Inclusion of Patient Functional and Social Complexity Improve Predictiveness?

Medicare’s Hospital Readmissions Reduction Program (HRRP) was intended to encourage hospitals to improve care for older adults. However, the program has raised health equity concerns because its risk-adjustment model does not account for patient social complexity; the concern is that HRRP may aggravate healthcare disparities by penalizing financially challenged hospitals and reducing their resources to improve care.1 While the HRRP assesses hospitals for penalties based upon readmission performance that is adjusted for patient age, sex, and clinical severity of illness, it does not account for functional and social patient factors.