In the fourth year of the Hospital Readmissions Reduction Program, which makes hospitals pay closer attention to their patients after discharge, half of the nation’s hospitals will be penalized for Medicare because of their readmissions.
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Elaine Wong Eakin, executive director of patient education nonprofit California Health Advocates, hopes the Centers for Medicare & Medicaid Services penalties will gradually alleviate what she said has been a long-standing problem for Medicare patients.
Shannon’s fiscal year 2015 penalty was 0.81 percent, but that dropped to a 0.31 percent penalty for the FY2016, which starts in October, said Diane Zeitler, associate vice president of quality at Shannon.
Local results are as follows.
Lancaster General Hospital’s penalty will rise from 0.28 percent to 0.35 percent. Over the full 4 years of the program, 4 hospitals have received the maximum penalty every year: Harlan ARH Hospital and Monroe County Medical Center in Kentucky; Regional Hospital in Tennessee; and Franklin Medical Center in Louisiana. That’s 65 percent of hospitals that participated in the program statewide – higher than the 54 percent of hospitals that were penalized nationally, according to a Kaiser Health News analysis of the agency’s data.
The penalties have drawn criticism since their inception.
This year’s penalties are based on readmissions occurring between July 2011 and June 2014 for Medicare patients who were originally in the hospital for one of the following conditions: heart attack, heart failure, pneumonia, chronic obstructive pulmonary disease or elective hip and knee replacements.
In a rule released last week, regulators declined to change its process, writing that they “continue to have concerns about holding hospitals to different standards for the outcomes of their patients of low sociodemographic status because we do not want to mask potential disparities or minimize incentives to improve the outcomes of disadvantaged populations”.
In California, 224 hospitals will be penalized, including multiple facilities operated by Dignity Health, Sutter Health, Kaiser Permanente and the University of California.
Physicians Regional spokeswoman Marti Van Veen said the hospital system has formed a care transitions collaborative to identify and launch strategies to reduce readmissions. “They’re looking beyond the hospital walls and into the community for a support system, to make sure the patient can get to that follow-up appointment”. A total of 506 hospitals will lost at least 1% of their Medicare payments. The penalty is based on the difference between the projected rate of unplanned readmissions and the actual rate, according toKHN.
In fact, two U.S. senators have introduced a bill to include consideration of the patients’ demographics when figuring hospital penalties.
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“A third still have some work to do”, Holmes said. Hospitals with the lowest profit margins were 36 percent more likely to be penalized than those in better financial shape, the essay said. He added that the hospital’s internal data indicates that its penalty should drop again next year. “It’s good care for the patients, and it keeps people out of the hospital”. Patients at the “urban safety-net hospital” come from “a wide spectrum of socioeconomic backgrounds”, she said. “Patients who are at-risk of readmission are given specific information about symptoms to look for, when to contact their physician, and if necessary, when to come back to the hospital or seek emergency treatment”.
