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Hospitals Penalized for Excess Readmissions


The government will start penalizing hospitals for excess readmission rates, docking Medicare reimbursements by as much as 1% this first year and more in subsequent ones.

The 30-day readmission rate for U.S. heart attack patients is higher than for patients in other countries and now hospitals will pay the price. The government will penalize more than 2,000 hospitals starting in October because their patients are readmitted soon after discharge, Kaiser Health News reported.

Using readmission measures for acute myocardial infarction, heart failure and pneumonia, the Centers for Medicare and Medicaid Services (CMS) calculated a payment adjustment to hospitals. CMS calculated for readmission — defined as admission within 30 days of discharge — rates in excess of the national average.

After analyzing the data, Kaiser Health News determined that Arkansas, Illinois, Kentucky, Massachusetts, Mississippi, New Jersey, New York and the District of Columbia will be hit with the heaviest penalties.

According to Kaiser:

Nearly 2 million Medicare beneficiaries are readmitted within 30 days of release each year, costing Medicare $17.5 billion in additional hospital bills. The national average readmission rate has remained steady at slightly above 19% for several years, even as many hospitals have worked harder to lower theirs.”

The hospitals being penalized will forfeit $280 million in Medicare funds, according to Kaiser. The maximum penalty allowed is 1% of base Medicare reimbursements, and next year the penalty will increase to 2% and then 3% the following year.

Read more:

$5.6 Billion in Suspicious Medicare Billing

Proposed Medicare Cuts May Leave 287,000 Hospital Jobs at Risk

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