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The Jayne Koskinas Ted Giovanis Foundation for Health and Policy fosters public discussion around health care policy to benefit the public good.  Through research, white papers and other projects, the Foundation serves as an honest, independent broker of ideas and actions designed to achieve the competing goals of cost reduction, expanding access and improving quality.

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Wednesday, April 11, 2018

The Problem with Peer Grouping when Adjusting for SES in Calculating Readmission Penalties

A study published this month demonstrates and quantifies problems associated with the use of peer grouping to adjust for socio-economic status (SES) in the calculation of hospital readmission penalties, and advocates adoption of a patient-level calculation developed by JKTG Foundation Executive Vice President for Research and Policy, J. Graham Atkinson.

Search Tags: SES , Medicare , Readmissions

Tuesday, July 5, 2016

Healthy Debate: Building an SES adjustment directly into the Medicare Re-Admission Penalty (and VBP more generally) to avoid unintended consequences

Congress is considering legislation to require that CMS take account of socio-economic status (SES) in their readmission penalty calculation. The fact that action is being taken on this issue is to be applauded, as it is unconscionable that CMS has for years ignored the evidence and arguments that socioeconomic status influences readmission rates, and has penalized hospitals that treat a high proportion of patients of low SES. However, this situation also illustrates the problems that occur when legislation is required to make the regulators behave responsibly.

Wednesday, June 1, 2016

Healthy Debate: CMS hypocrisy -- disparity effort vs no SES adjustment

CMS recently launched an interactive map that helps identify disparities and chronic conditions among the Medicare population to better understand the social determinants of health and their effects. Estimates indicate that as much as 80% of disparities are driven by social determinants. Yet, with all its data, analytics, and understanding that social determinants impact health the agency continues to refuse to adjust for these factors by including any social economic status (SES) adjuster in their payment and quality measurement systems.

Search Tags: Healthy Debate , SES