To determine the effects of including diagnostic and utilization data from a secondary payer on readmission rates and hospital profiles.
Data Sources/Study Setting
Veterans Health Administration () and Medicare inpatient and outpatient administrative data for veterans discharged from 153 hospitals during 2008–2010 with a principal diagnosis of acute myocardial infarction, heart failure, or pneumonia.
We estimated hospital‐level risk‐standardized readmission rates derived using data only. We then used data from both and Medicare to reestimate readmission rates and compared hospital profiles using two methods: Hospital Compare and the implementation of the Hospital Readmissions Reduction Program ().
Data Collection/Extraction Methods
Retrospective data analysis using hospital discharge and outpatient data matched with Medicare fee‐for‐service claims by scrambled Social Security numbers.
Less than 2 percent of hospitals in any cohort were classified discordantly by the Hospital Compare method when using ‐only compared with /Medicare data. In contrast, using the method, 13 percent of hospitals had differences in whether they were flagged as having excessive readmission rates in at least one cohort.
Inclusion of secondary payer data may cause changes in hospital profiles, depending on the methodology used. An assessment of readmission rates should include, to the extent possible, all available information about patients' utilization of care.
