Key Points
Question
Is inclusion of Medicare Advantage patients in hospitals’ 30-day risk-standardized readmission rates associated with changes in hospital performance measures and eligibility for financial penalties?
Findings
In this cohort study of 4070 US acute care hospitals, inclusion of data from Medicare Advantage patients was associated with changes in the performance and penalty status of a substantial fraction of US hospitals for at least 1 of the outcomes of acute myocardial infarction, congestive heart failure, or pneumonia.
Meaning
These findings suggest that there is a need for the Centers for Medicare & Medicaid Services and other policy makers to consider incorporating outcomes of all hospitalized patients, regardless of insurance coverage source, in assessments of hospital quality.
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