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March 26, 2024
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High hospital quality ratings, rankings linked with decreased TJA readmission penalties

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Key takeaways:

  • High hospital ratings and recognition on national rankings were associated with decreased readmission penalties after total joint arthroplasty.
  • No other quality rating systems were associated with penalties.

Results showed high Medicare hospital star ratings and recognition on the top 50 orthopedic hospital rankings from U.S. News & World Report were associated with reduced likelihood of readmission penalties after total joint arthroplasty.

Jeffrey B. Stambough, MD, and colleagues from the University of Arkansas for Medical Sciences used the 2022 Inpatient Prospective Payment System Final Rule to analyze readmission penalties after total hip and total knee arthroplasty at 2,286 hospitals. According to the study, researchers analyzed six hospital quality rating systems and five hospital characteristics.

Hospital corridor
High Medicare hospital star ratings and recognition on the top 50 orthopedic hospital rankings from U.S. News & World Report were associated with decreased readmission penalties after TJA. Image: Adobe Stock

Stambough and colleagues found hospitals with higher Medicare overall hospital quality star ratings had a “significantly lower likelihood” of readmission penalties after THA and TKA compared with hospitals with lower quality star ratings. They also found hospitals ranked in the top 50 of the U.S. News & World Report’s best hospitals for orthopedics had a lower likelihood of penalties compared with hospitals not included in the top 50.

Jeffrey B. Stambough
Jeffrey B. Stambough

None of the other four quality rating systems were associated with readmission penalties, according to the study. However, researchers noted readmission penalties were most common for hospitals with fewer TJA discharges, hospitals with 100 to 499 beds, teaching hospitals and safety net hospitals. They noted hospitals located in the Midwest and West had lower risks of penalization.

“Our research findings highlight the limitations of certain quality rating systems by demonstrating that some do not necessarily signify improved patient outcomes in total joint care, which is highly relevant information for health care providers and consumers who rely on these systems for decision-making,” Stambough told Healio. “There are implications in the future if insurers or payers decide to drive patients toward higher-ranking centers, as we’ve shown the outcomes are not necessarily improved,” he concluded.