Safety net hospitals will see a drop in readmissions penalties of about 25% on average for fiscal year 2019 as a result of a change in the Hospital Readmissions Reduction Program, according to a Kaiser Health News analysis.
Some penalties are being cut by half or more, and 65 safety-net facilities that were penalized last year will see no dock at all this year, KHN found.
- The change in calculation was part of the FY 2018 Inpatient Prospective Payment Systems rule. Hospitals are now judged on HRRP performance in comparison with other hospitals that have similar dual eligible populations.
As the move toward value-based reimbursement moves full steam ahead, government payers in particular struggle with how to accurately evaluate hospitals on quality measures. Safety-net facilities have long cautioned they will be unfairly penalized by some metrics as a result of their patient population, which usually includes more people with chronic conditions.
HRRP is seen as a way to improve care and reduce hospital readmissions, a major healthcare cost driver. However, safety-net hospital supporters say penalizing those facilities for readmissions is unfair because their patients are more likely to suffer complications after leaving facilities given their socioeconomic status.
America's Essential Hospitals, which represents more than 325 safety-net hospitals, said the payment system that began penalizing hospitals who readmitted patients within 30 days of discharge in fiscal year 2013 has unintended consequences for its members. AEH released a data brief in 2015 that found that hospitals with many low-income patients were 2.67 times more likely than other hospitals to receive penalties under HRRP for fiscal year 2016.
Bruce Siegel, CEO of AEH, told Healthcare Dive the organization is pleased with change. "We're heartened to see that this analysis validates our work to have the readmissions program reflect the challenges vulnerable patients and underserved communities face," he said in a statement. "Essential hospitals would otherwise be deprived of needed resources, as they're penalized for social and economic factors outside their control."