[Answered]: Under the Hospital Readmissions Reduction Program…

Under the Hospital Readmissions Reduction Program (HRRP), hospitals are penalized for excess readmissions within 30 days of discharge. A major health system notices that readmission penalties cost them millions even though many high-risk patients require ongoing care. What is the most effective strategy to avoid penalties while maintaining revenue? Extend initial inpatient stays just long enough to avoid classifying follow-ups as readmissions. Shift high-risk discharges to home health agencies reimbursed under a different billing code. Utilize social determinants of health (SDoH) coding to justify increased payments for at-risk populations. Lobby CMS to modify HRRP methodology to include risk-adjusted factors. Reclassify readmissions as observation stays to avoid inpatient classification. Deny high-risk patients admission in the first place to maintain an artificially low readmission rate.