Hospitals brace for Medicare targets on high readmission rates

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Hospitals can expect renewed efforts from the Centers for Medicare & Medicaid Services (CMS) to cut readmissions; the hospitals with the highest rates can lose up to 3 percent of reimbursements, effective October 2012.

Under pressure to increase care and save money, Medicare soon will release a final rule aimed at cutting hospital readmissions, which make up $26 billion in one decade, according to a Kaiser Health News and Washington Post article on Saturday.

"The incentives we're putting into place have created a whole new way to think about hospital care," said Jonathan Blum, deputy administrator of the federal CMS, in the article.

Health experts, however, point out that there is a big difference between avoidable and unavoidable readmissions of patients. Some inner-city hospitals that deal with sicker patients may be unfairly penalized.

How many hospitals will be affected by the new Medicare rule? Almost 7 percent of acute care hospitals experience higher-than-average readmission rates for heart failure, heart attack, or pneumonia, according to the article.

With readmission rates affecting the bottom line, hospitals will feel the financial consequences to take action. Many hospitals already are experimenting with transitional care programs that help manage the patient's care from the hospital to their home. The Medicare reimbursement change could have lasting effects on care coordination with hospitals thinking about patients on an outpatient basis, rather than solely inpatient.

For more information:
read the Kaiser-Washington Post article

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