Jordan Rau from Kaiser Health News reports that the majority of America’s hospital have been on the receiving end of penalties by Medicare for re-admission issues. Specifically, hospitals were penalized upwards of $400 million nationwide as patients frequently returned within a month after being discharged.
This marks the fourth year of these federally administered penalties. Nearly 2600 hospitals across the country will now receive less money for each Medicare patient that stays in their facilities, regardless if they return or not within the month. The measures are scheduled to come into effect beginning October of 2015. This program is in place to incentivize hospitals to focus more on patients’ health after they have been discharged.
The Hospital Readmissions Reduction Program, in its fourth year, has engendered a decrease in, as the name would suggest, readmissions. But, experts would point out that about twenty percent of Medicare patients still end up being readmitted. Many hospitals have deemed these measures to be overly harsh and unfair as they are penalized even if they do improve from year to year.
Medicare used data for patients who were treated for any of the following five conditions: pneumonia, heart failure, heart attack, elective knee or hip replacements, and chronic lung problems. The acceptable level of readmissions was determined depending on the composition of the patients and industry standards. If a hospital’s readmissions surpassed this number, it is subject to fines.
For this year, the medicare payment reduction is .61 percent per patient, on average. This average and the total number of fined hospitals both decreased from the previous year. More than 75% of the hospitals in Alabama, Florida, New Jersey, New York Virginia, Washington D.C., Connecticut, Massachusetts are recipients of the fines.
Of the more than two-thousand hospitals that find themselves excused from the fine, the vast majority were automatically exempt rather than meeting the threshold of readmissions.
Hospitals across the nation have been asking Congress and Medicare to consider the socio-economic composition of their patients while determining the appropriate number of readmissions and the severity of the penalties. Their lobbying has not gone unheeded as the Medicare Payment Advisory Commission has advised congress to consider altering the structure of the imposed penalties.