Hospitals Penalized by Medicare For Excess Readmissions

The 2010 Health Care Law, in an effort to force improvements in hospital quality, has authorized penalties for hospitals based on readmission rates. Starting in October 2012, more than 2,000 hospitals will be penalized by the government because many of their patients are readmitted soon after discharge. According to a article, two New York City Health and Hospitals Corp. facilities are among the New York hospitals with the lowest rates of preventable readmissions. According to Chief Medical Officer Dr. Ross Wilson, HHC’s North Central Bronx Hospital doesn’t admit patients in the category of heart attacks. Instead, they are treated at nearby Jacobi or Montefiore. “If you don’t have many patients in those categories [health failure and heart attacks], you look much better from that point of view, and you don’t have a penalty,” said Dr. Wilson. According to Kaiser Health News staff writer, Jordan Rau, hospitals that treat large numbers of low-income patients tend to have higher readmission rates and will be hit particularly hard. Many hospitals are working hard to improve the standard of care and prevent avoidable readmissions, but the sickness of the patient as well as the socio-economic background plays a major role in admission rates. Atul Grover, chief public policy officer for the Association of American Medical Colleges, called Medicare’s new penalties “a total disregard for underserved patients and the hospitals that care for them.” How will these Medicare penalties really affect patient care? Will a lower readmission rate reflect a higher mortality rate? Does a lower readmission rate improve quality of care or just eliminate care altogether? Will the low-income population and the hospitals that serve them suffer penalties based on conditions that are really not in the control of the hospitals? Should Medicare consider recalibrating its formula for determining quality of care with a more complete background that includes mortality rate, readmissions, category of sickness, socio-economic background and any other factors that reflect the “quality of care”?

05. September 2012 by Ruth Folger Weiss
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