Transitional care models to combat readmissions

Hospitals prepare for Medicare penalties by revamping discharge process
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By Karen Cheung-Larivee

In less than a week, two-thirds of hospitals will be hit with Medicare penalties, according to the Medicare Payment Advisory Commission. Effective for discharges starting on Oct. 1, 2012, the Hospital Readmissions Reduction Program, under the Affordable Care Act, requires that Centers for Medicare & Medicaid Services reduce reimbursements to Inpatient Prospective Payment System (IPPS) hospitals with excess readmissions. Hospitals that perform worse than average, with patients coming back to the hospital within 30 days of discharge, will be dinged with up to a 1 percent penalty, worth up to seven figures--a rate that will only increase as time goes on.

According to the CMS website, IPPS hospitals will be hit with the following penalties:

  • October 2012: Up to 1 percent on acute myocardial infarction, heart failure and pneumonia
  • October 2013: Up to 2 percent
  • October 2014: Up to 3 percent, with additional measures, expected around chronic obstructive pulmonary disease, vascular problems, angioplasty and heart bypass surgical complications

Click through to find out more on transitional care models taking hold at hospitals across the country in efforts to curb readmissions.