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Medicare Shared Savings Program and readmission rate among ischemic stroke patients

Citation

Kim, Yeunkyung; Glance, Laurent; Holloway, Robert; Li, Yue (2021), Medicare Shared Savings Program and readmission rate among ischemic stroke patients, Dryad, Dataset, https://doi.org/10.5061/dryad.02v6wwq05

Abstract

Objective

Hospitals participating in the Medicare Shared Savings Program (MSSP) share with the Centers for Medicare and Medicaid Services (CMS) the savings generated by reducing readmissions. Our aim was to determine whether MSSP is associated with changes in readmissions and mortality for Medicare patients hospitalized with ischemic stroke, and whether MSSP has a different impact on safety-net hospitals (SNHs) compared to non-SNHs.   

Methods

This study was based on the CMS Hospital Compare data for risk-standardized 30-day readmission and mortality rates for Medicare patients hospitalized with ischemic strokes between 2010 and 2017. With propensity score matched sample, hospital-level difference-in-difference (DID) analysis was used to determine whether MSSP was associated with changes in hospital readmission and mortality as well as to examine the impact of MSSP on SNHs compared to non-SNHs. 

Results

MSSP-participating hospitals had slightly greater reductions in readmission rates compared to matched non-participating hospitals (difference, 0.25 percentage points; 95% CI: -0.42, -0.08). Mortality rates decreased among all hospitals, but mortality reduction was not significantly different between MSSP-participating hospitals and matched hospitals (difference, 0.06 percentage points; 95% CI: -0.28, 0.17). Prior to MSSP, readmission rates in SNHs were higher compared to non-SNH, but MSSP did not have a significantly different impact on hospital readmission and mortality rates for SNH and non-SNHs.

Conclusion

MSSP led to slightly fewer readmissions without increases in mortality in patients hospitalized with ischemic stroke. Similar reductions in readmission rates were observed in SNHs and non-SNHs participating in MSSP, indicating persistent gaps between SNHs and non-SNHs.