Medicare Program Associated With Narrowing Hospital Readmission Disparities Between Black And White Patients

The Hospital Readmissions Reduction Program has been associated with improvements in readmission rates, yet little is known about its effect on racial disparities. We compared trends in thirty-day readmission rates for congestive heart failure, acute myocardial infarction, and pneumonia among non-Hispanic whites versus non-Hispanic blacks, and among minority-serving hospitals versus others. During the penalty-free implementation period (April 2010-September 2012), readmission rates improved over pre-implementation trends (January 2007-March 2010) for both whites and blacks, with a significantly greater decline among blacks than among whites (-0.45 percent versus -0.36 percent per quarter, respectively). In the period October 2012-December 2014, after penalties began, readmission improvements slowed for both races. Following a similar pattern, minority-serving hospitals saw greater reductions in readmissions than other hospitals did. Despite the narrowing of the two race-based gaps after announcement of the Hospital Readmissions Reduction Program, both persist. It remains to be seen whether new policy efforts will narrow these gaps and reduce the disproportionately high penalties that minority-serving hospitals face.