Mr. Carlos Irwin Oronce, an MD/MPH student, and Mr. Hui Shao, a doctoral student, both in the department of global health systems and development at the Tulane School of Public Health and Tropical Medicine, were awarded best student abstract in the poster presentation at the 2014 AcademyHealth annual research meeting in San Diego.

[Photo: Mr. Carlos Irwin Oronce with the winning poster]

Their poster addressed how the Centers for Medicare and Medicaid Services (CMS) levies penalties on hospitals with higher than expected 30-day readmission rates for a handful of medical conditions, but will include total hip arthroplasties (hip replacements) starting this upcoming fiscal year.

According to the abstract, hospitals are rightfully worried as the penalties will include up to 3 percent of reimbursements. Already, CMS has issued $227 million in penalties, much of which has fallen disproportionately on hospitals serving high numbers of minority patients.

While previous studies have looked at a variety of medical conditions, little is known regarding disparities in patients receiving a hip replacement. Mr. Oronce and Mr. Shao, on reviewing 66,813 discharges from the state of California, found that African-American patients were 42 percent more likely than White patients to come back to the hospital within the first 30 days after a hip replacement surgery, while Hispanic patients were 23 percent more likely.

The difference in outcome was determined by taking into account the patient’s age, gender, co-morbidities, community poverty, and the type of insurance the patient had. Private payers often follow CMS’s lead on reimbursement policies, and, thus, readmission penalties will have a significant impact on hospital finances.

The abstract concluded that as hospitals accelerate efforts to improve their transitions of care and reduce readmissions, payers should be mindful of how readmission penalties may impact hospitals that care for vulnerable patient populations.