The CMS posted its third round of readmission penalties, which will affect Medicare reimbursements from Oct. 1, 2014, through Sept. 30, 2015.
The tally of hospitals subject to fines next year is about 400 more than in the first two years of the program (2,225 in fiscal 2014 and 2,217 in fiscal 2013), according to data obtained from Kaiser Health News.
Of the ones facing the newest round of penalties, 39 received the maximum fine of 3%. Twelve of them had zero penalties in the first two years of the program, and nine of them (about 23%) are in Kentucky.
Because the maximum penalty is higher in 2015, comparing changes from 2014 to 2015 requires measuring the penalty as a percentage of the largest possible reduction. By this measure, 13 hospitals improved their standing by more than 50%, but 75 hospitals did at least 50% worse.
Only 769 hospitals will not see a Medicare pay cut because of readmissions. Among those for which data is available from all three years, 571 have never been penalized.
The Hospital Readmissions Reduction Program is a quality-improvement effort created as part of the Patient Protection and Affordable Care Act. Hospitals with excess numbers of patients returning within 30-days of discharge following treatment for heart attack, heart failure and pneumonia began having Medicare payments docked up to 1% in fiscal 2013. That number increased to 2% in fiscal 2014.
In fiscal 2015, the fine increased to 3%, and two additional measures were added for readmissions rates following treatment for chronic obstructive pulmonary disease (COPD) and total hip and total knee replacements, which may account for the increased number of fines.
The Hospital Readmissions Reduction Program is a quality-improvement effort created as part of the Patient Protection and Affordable Care Act. Hospitals with excess numbers of patients returning within 30-days of discharge following treatment for heart attack, heart failure and pneumonia began having Medicare payments docked up to 1% in fiscal 2013. That number increased to 2% in fiscal 2014.
In fiscal 2015, the fine increased to 3%, and two additional measures were added for readmissions rates following treatment for chronic obstructive pulmonary disease (COPD) and total hip and total knee replacements, which may account for the increased number of fines.
Policy experts are increasingly raising concerns that hospitals in poor communities are unfairly punished by the program after observing that safety net providers were more likely to receive penalties in the first two years of the program.
“We expect this trend will continue,” Akin Demehin, senior associate director of policy for the American Hospital Association, said in a statement. The CMS, he said, has “raised the financial stakes” but continues to resist requests to adjust for socioeconomic factors.
source (list of hospitals and penalties at website)
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