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Hospital Readmissions Reduction Program Methodology

qualitynet.cms.gov · 2 words · saved by 1 readers

The Centers for Medicare & Medicaid Services (CMS) calculates the Hospital Readmissions Reduction Program payment reduction as a weighted average of hospital performance across the readmission measures during the Hospital Readmissions Reduction Program performance period. CMS applies the payment reduction to all Medicare fee-for-service base operating diagnosis-related group (DRG) payments during the fiscal year (FY). CMS calculates the payment reduction for each hospital based on its performance during the Hospital Readmissions Reduction Program performance period (July 1, 2021, to June 30, 2024, for FY 2026) using the following steps: The formula for the payment reduction is available in the following PDF. More information about the payment reduction methodology is available in the Hospital Readmissions Reduction Program Payment Reduction Methodology Infographic on the Resources - Opens in new browser tab - Opens in new browser tab page of the QualityNet website. More information on

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