Hospital Readmissions Reduction Program (HRRP) Archives

Archived Supplemental Data Files refer to the Archived Supplemental Data Files page on CMS.gov for the supplemental data released with the Inpatient Prospective Payment System (IPPS) final rule each fiscal year (FY).

Archived Finalized Policies

In the FY 2022 IPPS final rule, the Centers for Medicare & Medicaid Services (CMS) finalized the following policies:

• Adopted a measure suppression policy due to the COVID-19 Public Health Emergency
• Temporarily suppressed the pneumonia readmission measure in FY 2023 HRRP payment reduction calculations due to COVID-19’s substantial impact on this measure
• Revised the performance periods for FY 2022, FY 2023, and FY 2024 to exclude data from December 1, 2019 through June 30, 2020
• Adopted a policy to automatically use Medicare Provider Analysis and Review (MedPAR) data corresponding to the applicable period, beginning with the FY 2023 program year

In the FY 2021 IPPS final rule, the CMS finalized the following policies:

• Updated the policy to automatically adopt applicable periods beginning in the FY 2023 program year

In the FY 2020 IPPS final rule, CMS finalized the following policies:

• Adopted a measure removal policy to align with other quality reporting and quality payment programs
• Updated the definition of dual eligible for calculating dual proportions beginning in the FY 2021 program year
• Adopted a subregulatory process to address future non-substantive changes to the to the payment adjustment factor calculation

In the FY 2019 IPPS final rule, CMS finalized the following policies:

• Codified previously finalized definitions of dual-eligible patients, dual proportion, and the applicable period for dual eligibility
• Reviewed HRRP’s measures to align with the Meaningful Measures Framework and de-duplicated measures across programs (beginning with FY 2020, the six HRRP readmission measures will be removed from the Hospital Inpatient Quality Reporting Program)

In the FY 2018 IPPS final rule, CMS finalized the following policies:

• Changed the methodology to calculate the payment adjustment factor in accordance with the 21st Century Cures Act to assess a hospital’s performance relative to other hospitals with a similar proportion of patients who are dually eligible for Medicare and full-benefit Medicaid beginning with the FY 2019 program
• Updated the Extraordinary Circumstances Exemption policy to allow hospitals to submit a form signed by the hospital’s Chief Executive Officer or designated personnel and to allow CMS to grant Extraordinary Circumstances Exemptions because of CMS data system issues that affect data submission

In the FY 2017 IPPS final rule, CMS finalized the following policy:

• Revised the date for publicly reporting hospitals’ excess readmission ratio on Hospital Compare to allow CMS to post data as soon as possible after the review period 

In the FY 2016 IPPS final rule, CMS finalized the following policies:

• Adopted an Extraordinary Circumstances Exemption policy allowing hospitals that experience a significant disaster or other extraordinary circumstance beyond the hospital’s control (for example, hurricane or flood) to request an exemption
• Refined the pneumonia readmission measure by expanding the measure cohort to include additional pneumonia diagnoses: (1) patients with aspiration pneumonia and (2) sepsis patients coded with pneumonia present on admission, excluding severe sepsis, beginning with the FY 2017 program

In the FY 2015 IPPS final rule, CMS finalized the following policy:

• Expanded the applicable conditions beginning with the FY 2017 program to include patients admitted for coronary artery bypass graft (CABG) surgery

In the FY 2014 IPPS final rule, CMS finalized the following policies:

• Applied an algorithm to account for planned readmissions to the readmission measures
• Expanded the applicable conditions beginning with the FY 2015 program to include (1) patients admitted for an acute exacerbation of chronic obstructive pulmonary disease (COPD), and (2) patients admitted for elective primary total hip arthroplasty (THA) and/or total knee arthroplasty (TKA)

In the FY 2013 IPPS final rule, CMS finalized the following policies:

• Defined the hospitals subject to HRRP
• Established the methodology to calculate the payment adjustment factor
• Established the process for hospitals to review their readmission information and submit corrections before the excess readmission ratios are public

In the FY 2012 IPPS final rule, CMS finalized the following policies:

• Defined readmission as an admission to a subsection (d) hospital within 30 days of a discharge from the same or another subsection (d) hospital
• Adopted readmission measures for the applicable conditions of acute myocardial infarction (AMI), heart failure (HF), and pneumonia
• Established a methodology to calculate the excess readmission ratio for each applicable condition, which uses a risk adjustment methodology endorsed by the National Quality Forum
• Established an applicable period of three years of discharge data and a minimum of 25 discharges for applicable conditions to be eligible to contribute to the payment adjustment

For more information on these policies, please refer to the IPPS Regulations and Notices in the Related Links section of the Hospital Readmissions Reduction Program homepage on CMS.gov.