One thing the academic literature is not so good at is explaining policy context. It’s pretty standard to nod lightly at a policy, not say very much about its details, and, by the time the article is published, to be out of date. Another thing academic literature tends to avoid explicitly — thought it is there behind the scenes — is the debate among opinion leaders. If you read closely and broaden your scope to the letters, perspective pieces, and editorials, you can almost see it, but it’s not the stock and trade of applied research journals.
That’s not a bad thing. And, you can get all this elsewhere. In the area of hospital readmissions, Jordan Rao has done some excellent work. In his November 26, 2012 New York Times article, he explains in a few sentences the policy landscape:
Medicare last month began levying financial penalties against 2,217 hospitals it says have had too many readmissions. Of those hospitals, 307 will receive the maximum punishment, a 1 percent reduction in Medicare’s regular payments for every patient over the next year, federal records show. [...]
The maximum penalty is set to double next October and then reach 3 percent of reimbursements in October 2015. Medicare also is expanding the list of conditions it will assess in setting punishments.
Right now it only evaluates readmissions of heart attack, heart failure and pneumonia patients, counting every rebound, even ones not related to the original reason for hospitalization. The penalties are based on readmission rates in the past and applied to future payments for all Medicare patients.
You can click through to read his quotes from Ashish Jha and Harlan Krumholz and others expressing opinions.
Rao has also published pieces on the broader set of hospital quality indicators upon which Medicare is or will be basing penalties and bonuses. Here’s his broad brush stroke. Here’s some finer-grained detail. Both pieces have links to more information.