Mt. Sinai CEO: Medicare readmission policies are unfair

The chief executive officer of the Mount Sinai Health System in New York City has argued that Medicare's current structure for managing patient readmissions penalizes hospitals that treat the poorest patients.

Kenneth L. Davis, M.D., made the argument in a blog post in The Hill. He said the Hospital Readmissions Reduction Program (HRRP) that the Centers for Medicare & Medicaid Services implemented in order to cut readmissions has had an adverse effect in punishing hospitals that serve safety-net populations. 

"Once out of the protective arms of hospital care, those most likely to relapse are people without a proper home environment in which to healthfully recover, or individuals lacking the literacy or social support to easily obtain and administer medications," Davis wrote. He cited instances where a patient couldn't obtain follow-up care because of a broken elevator at his apartment building and he was unable to climb stairs. Another patient had mold in his apartment building, aggravating his medical condition.

Davis' argument has found traction in academic arenas. A recent study in JAMA Internal Medicine concluded that a patient's level of education and employment were among the biggest indicators as to whether they would be readmitted. 

The American Hospital Association (AHA) has chimed in on the topic, saying that the fairness and long-term viability of the HRRP is in question.

As a solution, Davis suggested that CMS go beyond adjusting patient readmissions data for age, sex, discharge diagnosis and recent diagnoses, and include socioeconomic factors as well. The AHA and other members of the provider community have made similar requests.

To learn more:
- read The Hill article