B40-08 Evaluating Changes in Federally Funded COPD Research Before and After Implementation of the Hospital Readmissions Reduction Program

Rationale

Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality in the U.S. and places a substantial burden on healthcare systems due to frequent hospitalizations and high readmission rates. Approximately 20% of patients hospitalized for acute exacerbations of COPD (AECOPD) are readmitted within one month of discharge. Medicare added COPD as a condition within their Hospital Readmissions Reduction Program (HRRP) beginning in fiscal year (FY) 2015 to reduce these readmissions. However, despite concerns regarding HRRP’s impact on care quality and equity, it remains unclear whether the policy has improved patient outcomes. Therefore, this project aims to assess whether HRRP implementation galvanized COPD research for care quality improvement, by evaluating federally funded COPD research funding pre- and post-HRRP.

Methods

A systematic search of the NIH RePORTER database was conducted to identify federally funded COPD-related studies awarded between FY2000 and FY2025. Studies were categorized as pre-HRRP (FY2000-2012) or post-HRRP (FY2013-2025). Search terms included COPD-related conditions (e.g., COPD, emphysema, AECOPD) and care or utilization concepts (e.g., rehospitalization, follow-up visits, discharge planning). Included studies were U.S.-based, funded after FY2000, and focused on readmission reduction, care transitions, or acute care utilization. Among those eligible, the first year of funding and its funding amount, funding institute and grant type were extracted.

Results

Of 130 identified projects, 87 met eligibility criteria. Nearly twice as many eligible grants were funded post-HRRP (n = 60), compared with pre-HRRP (n = 27; p = 0.34). NIH was the primary funding agency (versus AHRQ, VA; p = 0.31), and large grants represented the most common grant type in both periods (p = 0.33). When analyzed by funding amount, NIH ($9.9M pre vs. $18.6M post-HRRP, p < 0.0001) and AHRQ ($461K pre vs. $1.48M post-HRRP, p < 0.0001) showed substantial increases in dollars funded (NIH and AHRQ post vs. pre funding: p < 0.0001). Similarly, large grants accounted for most funding with a significant increase from $9.1M to $16.3M post-HRRP (p < 0.0001). Other grant types categorized as small grants and training/career development also had significant increases in funding amount (p < 0.0001) (Table1).

Conclusion

Despite no statistically significant increase in the number of federally funded COPD care transition studies following HRRP implementation, there were twice as many funded grants and a significant increase in funding. These findings underscore the potential role of HRRP in galvanizing more research focused on optimizing COPD care quality and enhancing transitions between settings, aiming to ultimately reduce the high readmissions rate for patients with COPD.

This abstract is funded by: NIH NHLBI