Despite this success, the HRRP has been criticized on several fronts. Vulnerable patients are more likely to be readmitted to the hospital, and certain hospitals treat a higher share of such patients than others. Research bears this out. The current risk-adjustment methodology for the readmissions measures includes “clinically relevant” factors such as patient age and co-morbidities but, as mentioned, it does not account for any measures of patient socioeconomic status (SES), such as poverty status and social support. On the flip side, others, including CMS, argue that including SES risk adjustment is tantamount to letting hospitals “off the hook” for providing a lower quality of care.
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