Are there any winners under the readmission reduction program?

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Even the so-called winners are losers. Under Medicare's policy that docks up to 1 percent of payment for high readmissions that went into effect last week, hospitals that manage to escape the penalties won't get any extra rewards.

For instance, Penn State Milton S. Hershey (Pa.) Medical Center is one of the few that won't get dinged with the Medicare fine because of its low readmission rates. Chief Quality Officer Greg Caputo, who believes readmissions are mostly preventable, nevertheless, said the new program is "far from perfect," The Patriot-News reported.

Under the Hospital Readmission Reduction Program, 2,217 U.S. hospitals are facing penalties of a total of about $280 million, according to the newspaper.

Critics of the Affordable Care Act program say it's not so much of an incentive program as it is a punishment on hospitals.

"You don't get rewarded for not having high readmissions," Martin Ciccocioppo, vice president for research for the Hospital & Healthsystem Association of Pennsylvania said. "There aren't winners and losers under this program. CMS is just taking money away. It's hard to call that an incentive program."

It doesn't come as a complete shock that a policy aimed cutting Medicare reimbursements would face high scrutiny.

"Should we be surprised that industry is objecting?" John Santa, director of the Consumer Reports Health Ratings Center, told the Associated Press. "You would expect them to object to anything that changes the status quo."

Medicare Deputy Administrator Jonathan Blum added, "Clearly, it's captured their attention. It's galvanized the hospital industry on ways to reduce unnecessary readmissions. It's forced more parts of the healthcare system to work together to ensure that patients have much smoother transitions."

Although it's too early to tell how the penalties will directly affect readmissions, programs aimed at transitional care are already seeing lower readmission rates in New Jersey, a state with the majority of its hospitals facing the top 1 percent penalty, NJ Spotlight reported.

For more information:
- read the Patriot-News article
- see the AP article
- here's the NJ Spotlight article

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