This year, over 2,600 hospitals will be losing a combined $420 million in funding as a result of high readmission rates due to a PPACA policy introduced four years ago that fines hospitals with readmission rates above a certain level.

But some hospitals, such as teaching hospitals, say that the policy is unfair because their patients are typically poorer and sicker than those admitted by others. A new study from Harvard appears to validate this complaint.

The researchers looked at 29 different characteristics among a group of over 8,000 Medicare beneficiaries who were hospitalized between 2009 and 2012. The study sought to examine characteristics that current Medicare risk-adjustment models do not include, such as socioeconomic factors like education level.

The study found a strong link between some characteristics and hospital readmission rates. For example, education level is strongly correlated with the probability of chronic conditions, such as diabetes. Hospitals serving populations with high rates of such diseases are naturally going to have more patients frequently returning.

Speaking to the Washington Post, Michael McWilliams, one of the study authors, said that patients at hospitals with high readmission rates were, “less mobile, had more difficulty with activities of daily living, more chronic conditions, less education, lower income, lower assets, and the list goes on and on.”

The Centers for Medicare and Medicaid Services is emphasizing that it is sensitive to charges that the policy is counter-productive and is working to find more effective ways to encourage good care.

“We will continue to work with all stakeholders to seek feasible ways to encourage hospitals to reduce hospital readmissions while addressing any unintended consequences, particularly for those hospitals serving dual-eligible and low-income beneficiaries,” said Patrick Conway, CMS' chief medical officer, in a statement to the Post.

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PPACA could be punishing hospitals for serving the poor

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