Proposed Reimbursement Adjustments for Hospital Quality Based Program Potentially Preventable Readmissions

Hearing. The Texas Health and Human Services Commission (HHSC) conducted a public hearing on July 15, 2021, at 9:00 a.m., to receive public comments on the proposed use of unweighted potentially preventable readmission (PPR) results to assess hospital performance and potential reimbursement reductions. The meeting was convened by Jimmy Blanton. Mr. Blanton stated that the Background. The Texas HHSC Medicaid/CHIP HQBP measures hospital performance on potentially preventable complications (PPCs) and readmissions every state fiscal year (SFY). Eligible hospitals are subject to a reimbursement adjustment for poor performances in relation to state norms. Poor performance for PPRs is subject to a one or two percent reimbursement reduction depending on the magnitude of the result (see the schematic at the end of this document). In years past, HHSC has weighted PPR rates Proposal. The purpose of this amendment is to revise HHSC’s potentially preventable events program for reimburs