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Citing poor readmission rates, New Jersey hospitals lose estimated $23M in
The Record reports (http://bit.ly/1UmEUao ) the state had the highest percentage of hospitals penalized in the country.
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Zeitler said Shannon is committed to lowering the number of patients it readmits through programs such as its Shannon Care Coordination Program with Angelo State University. There have been concerns about the Hospital Readmission Reduction Program. It has hired more case managers, who make discharge plans for every patient, and a committee of the board of governors is focused on the issue, he said.
For example, the Legacy Good Samaritan penalty was 0.31 percent. Exact declines in readmissions in Western Pennsylvania were not immediately clear Tuesday, but an industry group said a three-year effort by 109 hospitals statewide had slashed the return trips 27 percent by December 2014.
The medical conditions included in the government’s re-admissions calculations include heart failure and heart attacks, pneumonia, chronic obstructive pulmonary disease, total hip and total knee replacement.
Lee Memorial’s hospital system places a high priority on doing all it can to help patients have a successful and long-lasting recovery and it is going to greater lengths than ever before to keep patients from being readmitted, Briggs said.
The fines will be applied to Medicare payments when the federal fiscal year begins in October.
Nevertheless, 54 percent of hospitals nationwide – and three Lancaster County facilities – will take a hit on all Medicaid admissions in the fourth year of the program, which is part of the Affordable Care Act.
Overall, Medicare’s punishments are slightly less severe than they were last year, both in the amount of the average fine and the number of hospitals penalized. Additionally, critical access hospitals and hospitals that specialize in certain types of patients, like children or veterans, are exempt.
As indicated by theanalysis, more than 75% of hospitals in Alabama, Connecticut, Florida, Massachusetts, New Jersey, New York, Rhode Island, South Carolina, Virginia and Washington, D.C., were penalized.
“The evidence suggests that hospitals that care for the chronically ill and low-income patients are far more likely to be penalized than other institutions”, the authors wrote, suggesting that Medicare consider patients’ socioeconomic status when assessing readmissions.
38 hospitals will face the maximum 3% penalty. As it did last year, Medicare also is giving bonuses and penalties based on a variety of quality measures.
Medicare also adjusts reimbursement rates based on evaluations of hospital-acquired infections and the use of best medical practices.
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At St. Joseph’s, which will be penalized 2.15 percent starting in October, many patients “have multiple acute diagnoses, and often face significant unique challenges upon discharge, which we continue to address”, said Nancy Collins, a spokeswoman. She said high Medicare and medical-assistance enrollment means regional hospitals are particularly dependent on the public programs for revenue.