Readmission penalties may hit safety nets hard

Safety-net hospitals, which are often under greater financial pressure than other acute care facilities, also are more likely to receive monetary penalties from the Centers for Medicare & Medicaid Services, according to a new study by the Commonwealth Fund.

CMS began the program last fall, penalizing hospitals as much as 1 percent for unnecessary readmissions of inpatients within 30 days of discharge. The agency also had halted payments to hospitals for care rendered during those readmissions.

The study found that disproportionate share hospitals are 30 percent more likely to have higher-than-average readmission rates than other facilities, according to study authors Julie Berenson and Anthony Shih.

"It may be especially difficult for safety net hospitals to reduce readmission rates," wrote Berenson and Shih, both Commonwealth Fund research associates. "Safety net hospitals care for a disproportionate share of vulnerable populations who are low-income, uninsured, underinsured, or on Medicaid. They have substantially higher rates of chronic health problems, disability, mental illness, and substance abuse, compared with the general population," they wrote.

However, many hospitals are simply counting their readmission penalties into the cost of doing business, MedPage Today noted. For instance, at hospitals where patient volume drives finances, the 1 percent penalty could cost the facility less money than reducing readmission rates.

To learn more:
- check out the Commonwealth Fund study (.pdf)
- read the MedPage Today article