Neighborhood Socioeconomic Status Impact On Medicare Rating for Heart Failure

Alex Blum, MD MPH FAAP Chief Medical Officer Evergreen Health, Baltimore MD Interview with:
Alex Blum, MD MPH FAAP
Chief Medical Officer
Evergreen Health, Baltimore MD 21211 What are the main findings of the study?

Dr. Blum: Accounting for the social risk of patients using a measure of neighborhood socioeconomic status (SES), did not alter the hospital rankings for congestive heart failure (CHF) readmission rates. Were any of the findings unexpected?

Dr. Blum: The findings were unexpected. Federal policies that reward/penalize a hospital’s high quality of care currently do not account for the “social risk” (e.g. homelessness, substance abuse, social isolation) of patients. Shouldn’t hospitals that cater to the socially disadvantaged receive more, not less resources? After all, these patients are harder to care for and may require more resources in the form of home visits, phone calls and close follow-up. However, social risk variables currently available in Medicare data (neighborhood socioeconomic status) may insufficiently characterize social risk. Therefore, researchers and policymakers have insufficient evidence to determine if current payment reform policies hurt hospitals that care for vulnerable populations. What should clinicians and patients take away from your report?

Dr. Blum: This research is a step forward in trying to understand the impact of social risk of hospital profiling based on 30-day readmission. A neighborhood measure of socioeconomic status did not impact hospital rankings in the Medicare program. What recommendations do you have for future research as a result of this study?

Dr. Blum: More research in this area is required to fully understand the impact of social risk factors on 30-day readmission. The data currently available in Medicare administrative files is limited and better data sources are required.


Impact of Socioeconomic Status Measures on Hospital Profiling in New York City

Alexander B. Blum, Natalia N. Egorova, Eugene A. Sosunov, Annetine C. Gelijns, Erin DuPree, Alan J. Moskowitz, Alex D. Federman, Deborah D. Ascheim,
and Salomeh Keyhani

Circ Cardiovasc Qual Outcomes. 2014;CIRCOUTCOMES.113.000520published online before print May 13 2014, doi:10.1161/CIRCOUTCOMES.113.000520

Last Updated on May 13, 2014 by Marie Benz MD FAAD