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Hospital Readmissions Reduction Program


Section 3025 of the 2010 Affordable Care Act (Public Law 111-148) requires the Secretary of the Department of Health and Human Services to establish a Hospital Readmissions Reduction Program whereby the Secretary reduces Inpatient Prospective Payment System (IPPS) payments to hospitals for excess readmissions beginning on or after October 1, 2012 (Fiscal Year [FY] 2013). The Centers for Medicare & Medicaid Services (CMS) adopted and publicly reported the following 30-day risk standardized readmission measures to comply with these requirements.

Effective Program Year Finalized in IPPS Rule 30-day Risk Standardized Readmission Measures
FY 2013 and FY 2014 FY 2012
  • Acute myocardial infarction (AMI)
  • Heart failure (HF)
  • Pneumonia
FY 2015 and FY 2016 FY 2014
  • AMI
  • HF
  • Pneumonia
  • Chronic obstructive pulmonary disease (COPD)
  • Elective primary total hip and/or total knee arthroplasty (THA/TKA)
FY 2017 FY 2015
  • AMI
  • HF
  • Pneumonia
  • COPD
  • Coronary Artery Bypass Graft (CABG) Surgery

Fiscal Year 2017 Hospital Readmissions Reduction Program

The FY 2017 Hospital Readmissions Reduction Program calculates Excess Readmission Ratios for six measures (AMI, HF, Pneumonia, COPD, CABG, and THA/TKA) to determine the payment adjustment factors for eligible hospitals. Hospitals have an opportunity to review their data to ensure that the Excess Readmission Ratios were calculated correctly. See the Review and Corrections page for more information on this process.

CMS releases hospitals’ Excess Readmission Ratios in the Inpatient Prospective Payment System/ Long-Term Care Hospital Prospective Payment System (IPPS/LTCH PPS) Final Rule, typically published in early August. CMS also plans to report the Excess Readmission Ratios for the risk-standardized readmission measures for the Hospital Readmissions Reduction Program on Hospital Compare later this year.

For information regarding the calculation of the payment adjustment factors, refer to the Scoring Methodology page or the Readmissions Reduction Program page on the CMS website.

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