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Is readmissions penalty a burden on safety net hospitals?

Under Medicare’s Hospital Readmissions Reduction Program (HRRP), which began Oct. 1, 2012, hospitals with readmission rates for certain target conditions that are deemed excessive will lose a percentage of their Medicare reimbursement.  A surprisingly high two-thirds of eligible hospitals will be penalized this year, to the tune of  $280 million total.  These authors note that safety net hospitals and large teaching hospitals are more likely to be penalized, jeopardizing their ability to care for the neediest patients.  Steps that might be taken to adjust the formula so as not to unduly penalize these hospitals are discussed:

  1. Adjust for socioeconomic status
  2. Weight according to when the readmission occurs — within a few days or at the end of 4 weeks
  3. Factor in the hospital mortality rate

Source: Joynt, K.E., and Jha, A.K.  A path forward on Medicare readmissions.  The New England Journal of Medicine, Mar. 6, 2011.  Click here for full text: http://www.nejm.org/doi/pdf/10.1056/NEJMp1300122 

For further study: Glass, D., Lisk, C., and Stensland, J.  Refining the Hospital Readmissions Reduction Program.  Washington, DC: Medicare Payment Assessment Commission, Sept. 7, 2012.  Click here for full text: http://www.medpac.gov/transcripts/readmissions%20Sept%2012%20presentation.pdf   Posted by AHA Resource Center, (312) 422-2050, rc@aha.org


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