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During Tax Bill Debate, Senator Cites Readmissions-Mortality Link

By Steven Porter  
   November 29, 2017

Republican sees JAMA study as evidence of ACA’s ‘deadly unintended consequence,’ calls for repeal of individual mandate.

Speaking from the floor of the U.S. Senate on Wednesday during debate over a GOP tax proposal, Sen. John Barrasso (R-Wy.) cited a recent JAMA Cardiology study as evidence that the Affordable Care Act has come with unintended consequences, at least one of them fatal.

The study that Barrasso mentioned found an alarming link between lower readmissions and higher mortality among Medicare patients hospitalized with heart failure, as HealthLeaders Media reported earlier this month. Medicare made a concerted effort to reduce readmissions among these patients and succeeded, but the program might have inadvertently increased the likelihood that those patients would die, the researchers wrote.

Barrasso placed blame for this increase in mortality on the 2010 healthcare law, which included a provision establishing the Medicare Hospital Readmission Reduction Program.

“There’s a program in the healthcare law that started to penalize hospitals if that Medicare patient was readmitted to the hospital within 30 days after they had been released from the hospital,” Barrasso said. “There are a number of reasons that may happen, but the goal was to penalize hospitals, and the goal—laudable goal—was to give patients better treatment, but that’s not what happened.”

Among the more than 115,000 fee-for-service Medicare beneficiaries studied, the 30-day risk-adjusted readmission rate dropped from 20% before the program was implemented to 18.4% afterward; the 30-day risk-adjusted mortality rate, meanwhile, increased from 7.2% to 8.6%, according to the study’s results.

“The hospitals succeeded in keeping people out to avoid the penalty, but people died in the process,” Barrasso said.

Steven Porter is editor at HealthLeaders.

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