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Editorials |

Admitting What We Do Not Know About Pneumonia ReadmissionsPneumonia Readmissions

Andrew F. Shorr, MD, MPH, FCCP; Marya D. Zilberberg, MD, MPH, FCCP
Author and Funding Information

From the Pulmonary and Critical Care Section (Dr Shorr), Medstar Washington Hospital Center; and Evimed Research Group (Dr Zilberberg).

CORRESPONDENCE TO: Andrew Shorr, MD, MPH, FCCP, Room 2A-68D, Medstar Washington Hospital Center, 110 Irving St NW, Washington, DC 20010; e-mail: Andrew.shorr@gmail.com


FINANCIAL/NONFINANCIAL DISCLOSURES: The authors have reported to CHEST the following conflicts: Dr Shorr has served as a speaker, consultant, or received research support from Actavis plc, Astellas Pharma, Bayer AG, Cardeas Pharma, Cempra, Cubist Pharmaceuticals, Pfizer Inc, Hoffmann-La Roche, Tetraphase Pharmaceuticals, and Theravance Biopharma. He has no conflicts relative to the content of this editorial. Dr Zilberberg has served as a consultant to and/or received research funding from Cubist Pharmaceuticals, Astellas Pharma, Pfizer Inc, CareFusion Corp, and Theravance Biopharma.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;148(1):4-6. doi:10.1378/chest.14-2987
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Section 3025 of the Affordable Care Act created the Hospital Readmission Reduction Program (HRRP).1 Under the HRRP, the Centers for Medicare & Medicaid Services (CMS) is charged with working to reduce hospital readmissions for select conditions. The initial focus of the HRRP was on acute myocardial infarction, congestive heart failure, and pneumonia.1,2 Recently, conditions covered by the HRRP initiative have expanded to include other diseases, such as COPD and coronary artery bypass grafting, whose patients are cared for by pulmonary and critical care physicians. If a hospital’s actual readmission rate at 30 days for a specific disease covered by the HRRP exceeds the expected readmission rate, the penalty in fiscal year 2013 was an up to 1% payment reduction.1,2 In the first year of the program, nearly 2,200 hospitals faced payment penalties.3 Although the total savings to the CMS from this program are small in light of its huge budget, the implications for hospitals can be significant. Many institutions, be they community or academic, face substantial financial pressures under the changing health-care delivery environment and operate on small margins. The penalty rate increases to a 3% clawback by fiscal year 2015.1,2

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