Is This the Most Astonishing Obamacare Result Ever?


Phil Price points us today to an intriguing chart from the Department of Health and Human Services. It shows readmission rates within 30 days of a hospital stay for Medicare patients—including both “official” readmissions and short-term “observations”—and it’s pretty stunning. When Obamacare passed, readmission rates started to fall dramatically almost instantly. They fell most sharply for a subset of conditions specifically targeted by Obamacare, and by a smaller amount for other conditions. If this is accurate, it means that hospitals could have done something about readmission rates all along, but they just hadn’t bothered. Only after Obamacare provided an incentive to get their readmission rates down did they do anything about it.

So how should we think about this? I’ll confess to some skepticism because the chart is almost too perfect. For four years the readmission rate is dead stable. Then, in a single month between December 2010 and January 2011 it suddenly drops by a full percentage point, and continues dropping for two years. This decline started about eight months after the passage of Obamacare, and it’s hard to believe that hospitals could react that quickly.

Then, the very instant that penalties begin for high readmission rates, everything stabilizes again. Apparently America’s hospitals unanimously decided that once they’d hit a certain level, that was good enough and they wouldn’t bother trying to improve even more.

Maybe. But even for those of us who believe in incentives, this is the damnedest response to a new incentive I’ve ever seen. I guess my advice is to treat this with cautious optimism. It looks like a great result, but as with most Obamacare outcomes, it’s too early to tell for sure how things are going to work out. When we have five or ten years of experience, we’ll start to be able to draw some concrete conclusions. Until then, we can say how things seem to be going so far, but not much more.

DOES IT FEEL LIKE POLITICS IS AT A BREAKING POINT?

Headshot of Editor in Chief of Mother Jones, Clara Jeffery

It sure feels that way to me, and here at Mother Jones, we’ve been thinking a lot about what journalism needs to do differently, and how we can have the biggest impact.

We kept coming back to one word: corruption. Democracy and the rule of law being undermined by those with wealth and power for their own gain. So we're launching an ambitious Mother Jones Corruption Project to do deep, time-intensive reporting on systemic corruption, and asking the MoJo community to help crowdfund it.

We aim to hire, build a team, and give them the time and space needed to understand how we got here and how we might get out. We want to dig into the forces and decisions that have allowed massive conflicts of interest, influence peddling, and win-at-all-costs politics to flourish.

It's unlike anything we've done, and we have seed funding to get started, but we're looking to raise $500,000 from readers by July when we'll be making key budgeting decisions—and the more resources we have by then, the deeper we can dig. If our plan sounds good to you, please help kickstart it with a tax-deductible donation today.

Thanks for reading—whether or not you can pitch in today, or ever, I'm glad you're with us.

Signed by Clara Jeffery

Clara Jeffery, Editor-in-Chief

We Recommend

Latest

Sign up for our newsletters

Subscribe and we'll send Mother Jones straight to your inbox.

Get our award-winning magazine

Save big on a full year of investigations, ideas, and insights.

Subscribe

Support our journalism

Help Mother Jones' reporters dig deep with a tax-deductible donation.

Donate

Share your feedback: We’re planning to launch a new version of the comments section. Help us test it.