Hospitals Penalized for Readmission Rates

August 13th, 2012

Medicare has published the list of hospitals that will face penalties because of high readmission rates beginning October, 2012; and many familiar names are on the list.

To see if the hospitals you use are on the list, visit:  Hospitals with 2013 Medicare Reductions

According to an article in Kaiser Health News, hospitals that serve the poor were hit harder than others.  Per Kaiser's article:  "The analysis of the penalties shows that 76 percent of the hospitals that have a lot of  low-income patients will lose Medicare funds in the fiscal year starting in October. Only 55 percent of the hospitals treating few poor patients are going to be penalized, the analysis shows.

Medicare disagrees that "safety-net hospitals" were disproportionately penalized writing:  "many safety-net providers and teaching hospitals do as well or better on the measures than hospitals without substantial numbers of patients of low socioeconomic status."

Per KLA's experience in this area, providers that serve the poor frequently have no choice but to readmit a sick patient who has been delivered to their office by relatives or friends who cannot nor will not further care for the patient.

With penalties being applied to hospitals regardless of the reason for readmission, providers must find alternatives to hospital stays for their poor patients; or face growing pressure from the hospital systems who are being penalized for readmissions.

CMS has proposed offering to pay providers for coordination of care thirty days after the patient leaves the hospital or skilled nursing facility.  (See our July 7 blog post for details.)

Tags: Readmission, Inpatient, Hospital


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