CMS to start readmission penalties


The Centers for Medicare and Medicaid Services wants hospitals to curb its patient readmissions starting this fall, or pay the price, Kaiser Health News reported.

According to KHN, CMS will begin recouping about $280 million in payments from about 2,200 hospitals beginning in October. Although the program is focusing on reducing nationwide readmissions, data analyzed by KHN suggest that hospitals in New Jersey, New York, the District of Columbia, Arkansas, Kentucky, Mississippi, Illinois and Massachusetts will be hit the hardest. Facilities that treat low-income patients will also be hit the hardest.

Under the penalty guidelines and as part of the data analysis, KHN said that 278 hospitals will likely face the harshest recoupment--a 1 percent loss of their base Medicare payments. Another 1,978 hospitals will face smaller recoupments.

Some of those facing recoupments are well-known academic medical centers, such as Mt. Sinai Medical Center in New York, reported WNYC, and the Mayo Clinic in Minnesota, according to Minnesota Public Radio.

The penalties are part of the Affordable Care Act, signed into law in 2010, and focuses on Medicare and Medicaid patients who are readmitted within 30 days of a prior hospital admission. However, studies have suggested that despite the looming penalties, the nationwide readmission rates have barely budged, according to KHN.

For more information:
- read the KHN article on readmission penalties
- here's the KHN article on readmission rates
- read the WNYC article
- read the Minnesota Public Radio article