Illinois fines hospitals $16.3M for excess readmissions

Hospitals already face federal financial penalties for readmission of discharged patients. But some states tack on even more fines.

That's the case in Illinois, which levied $16.3 million in penalties against 82 hospitals throughout the state for readmission levels considered to be too high, the Chicago Tribune reported. Many of the fines are in the form of recoupments of Medicaid payments. They represented the cost of the additional care provided to those patients.

Altogether, 147 hospitals throughout the state had unacceptable readmission levels, according to state officials. However, 65 hospitals avoided penalties by enacting measures to reduce readmissions. Such measures include improved discharge planning and coordination of care.

Hospital performance was based on inpatient claims data from 2010 and trending analysis for 2009, 2010 and part of 2011.

Although many hospitals had relatively negligible fines of less than $500,000, several facilities owed more than $1 million, including Presence Saints Mary and Elizabeth Medical Center; the University of Illinois Hospital & Health System; and the Ann & Robert H. Lurie Children's Hospital of Chicago.

Hospitals in Chicago had the highest readmission rates of any group of inpatient providers in the United States, according to data accumulated by the Centers for Medicare & Medicaid Services. However, the agency's own efforts have come under fire for a lack of transparency and data sharing among the hospitals.

"This was negotiated more than a year ago, and the hospitals in question had a year to make improvements to avoid these costs," said Julie Hamos, director of the Illinois Department of Healthcare and Family Services in a statement. "Not all readmissions can be prevented, but Illinois hospitals can do better."

Last month, several Illinois hospitals announced they had saved $132 million by cutting down on readmissions and facility-acquired infections.

To learn more
- read the Chicago Tribune article
- here's the Illinois statement

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