Dive Brief:
- New research has found that there's a meaningful correlation between the size of a city's population and the level of readmission penalties faced by hospitals there.
- Under the Medicare program, CMS cuts 2% from inpatient payments for hospitals with what it deems excessive readmissions for patients with acute myocardial infarctions, heart failure and pneumonia. That fine will climb to 3% in FY 2015, and will target readmits for COPD and knee and hip arthroplasty in addition to existing conditions.
- In keeping with their general finding that big-city hospitals paid more fines under the Medicare readmission prevention program, researchers from Wayne State University, Rush University and the University of Michigan found that facilities in Newark, NJ, Chicago, Philadelphia, New York City and Detroit experienced the highest average penalties in the last two reporting periods.
Dive Insight:
If big hospitals are being fined disproportionately, what does that say about the effectiveness of the readmissions reduction program? According to Muhammad Hamid of Wayne State, the penalties can actually have the opposite effect they're intended to have. He argues that at least in the case of urban hospitals, penalties are not only unlikely to improve care, they're likely to drain hospitals of the funds needed to turn problems around."If they don't get reimbursement, they will get more penalties," he told Modern Healthcare.
Still, there's little doubt that reducing needless readmissions is desirable, as it both saves money and keeps the focus on long-term patient health. To address readmissions issues, the Advisory Board has suggested that hospitals need to focus on key stages of care, including transition planning during the inpatient stay, discharge education and post-acute care coordination.