The Hospital Readmissions Reduction Program as a Clarifying Event for the Distribution of Responsibility in Healthcare

• In Event: 343 - Section on Medical Sociology Roundtables (one-hour)
  In Refereed Roundtable: Table 17. Healthcare Access and Delivery

Abstract

The Affordable Care Act, signed into law in 2010, included a provision -- the Hospital Readmissions Reduction Program (HRRP) -- to penalize Medicare-receiving hospitals for "excess" readmissions. This paper uses newspaper data to argue that the HRRP acts as a ‘clarifying event’ in understanding how responsibility is distributed within the health care system. By this, we mean an event that renders visible the often-invisible assumptions about and confrontations over who is responsible for patient health. The analysis found five dominant loci of responsibility -- the system, coordination/shared responsibility, the hospital, other providers and the patient -- each with an attendant consequence for health reform outcomes. The discourse on HRRP helped to attach, if not new, then restrengthened cultural meanings to health care, ones focused on the traditional responsibility of doctors, the responsibility of patients (which has a potential to turn to dependency/lack of autonomy) and the role of health organizations in communities.

Authors

• Carly Elizabeth Schall, Indiana University-Purdue University-Indianapolis

• Richard J Holden, Indiana University-Purdue University-Indianapolis