Medicare readmissions penalties will hurt COPD patients, teaching hospitals

Lung disease experts say Medicare's new policy to penalize excessive hospital readmissions for chronic obstructive pulmonary disease (COPD) will do more harm than good--hurting a vulnerable patient population and also the hospitals that care for them.

The Centers for Medicare & Medicaid Services (CMS) Hospital Readmission Reduction Program has added COPD to its list of conditions subject to penalties for readmitting patients too often within 30 days of discharge. Under the program, the agency will likely penalize more than 2,600 hospitals this fiscal year for readmissions of patients due to different ailments, including acute myocardial infarction, heart failure and pneumonia.

"Medicare is trying to improve patient care and reduce waste," Michael W. Sjoding, M.D., of the University of Michigan Institute for Healthcare Policy & Innovation in Ann Arbor told Medical News Today, "but the hospitals they are penalizing may be the ones who need the most help to do so."

Sjoding and his research team analyzed COPD data from 3,018 hospitals over a three-year period. They found that based on readmission rates in the past, teaching hospitals and safety-net hospitals will bear the brunt of the new financial penalties. These organizations typically treat a larger number of poor or medically complex patients with COPD who are at higher risk for readmissions due to socioeconomic and health factors.

They published their findings this month in the American Journal of Respiratory and Critical Care Medicine.

"If patients can't afford medications, or have unstable housing situation, they may end up being readmitted to the hospital," Sjoding said." No interventions to date have effectively and sustainably reduced COPD readmissions, so it's unclear what a hospital can do to prevent them."

The research echoes similar findings reported by Forbes last week that Medicare penalizes many hospitals for patient readmissions due to circumstances that are beyond their control, citing a study of patients being treated by the Henry Ford Health System in Detroit. It found that unmarried patients and patients from poor neighborhoods were significantly more likely to be readmitted to the hospital within 30 days of their initial discharge.

To learn more:
- here's the study
- read the article

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