CMS Levies Readmission Penalties on More Than 2,000 Hospital Facilities
Medicare last month began levying financial penalties against hospitals that do not meet certain standards for readmissions, Kaiser Health News/New York Times reports.
A total of 2,217 hospitals have been penalized, with 307 facing the maximum punishment of a 1% reduction in Medicare payments over the next year.
About 20% of Medicare beneficiaries are readmitted to the hospital within one month of their original visit, costing the federal government about $17 billion annually (Rau, Kaiser Health News/New York Times, 11/26).
A misunderstanding or misuse of medication often results in hospital readmissions, according to the Times' "The New Old Age." According to a survey published in the Journal of General Internal Medicine, 81% of older patients discharged from the hospital:
- Do not understand what their prescriptions are for;
- Were prescribed the wrong dosage or drug;
- Were taken off of a medication they needed; or
- Never filled a new prescription.
Failure to identify early warning signs of health problems also contributes to high readmission rates (Rau, "The New Old Age," New York Times, 11/27).
Readmissions Effort Central to ACA Goal
The effort to curb readmissions is central to the Affordable Care Act's goal of eliminating unnecessary care and reducing Medicare spending, which reached $556 billion in 2012. Hospital inpatient costs make up about 25% of those costs, and they are expected to grow by 4% annually, according to the Congressional Budget Office.
CMS will recoup about $300 million from the penalties this year. The maximum penalty will increase to 2% in October 2013 and 3% in October 2015. In addition, CMS will consider more types of conditions when assessing the penalties in the future -- the agency currently only evaluates readmissions for heart attack, heart failure and pneumonia patients.
Hospitals Make Efforts To Reduce Readmissions
Hospitals have begun making more concerted efforts to prevent readmissions, according to KHN/Times. To do so, hospitals are focusing on follow-up care by offering:
- Home visits from nurses;
- Transportation services;
- Culturally specific diet tips;
- Free medications; and
- Bathroom scales.
While most hospitals have attempted to reduce the number of readmissions, some are suspected of cutting patient stays to fewer than 24 hours to avoid billing for a hospital admission (Kaiser Health News/New York Times, 11/26).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.