Hospitals Expected to Forfeit $280 Million in Medicare Payments Due to Readmissions
More than 2,000 hospitals, including some nationally recognized ones, will be penalized starting in October under the Affordable Care Act's Hospital Readmissions Reduction Program, says a Kaiser Health News article. Together, these hospitals will forfeit about $280 million in Medicare payments over the next year for excess readmissions for heart attack, heart failure, and pneumonia.
The penalties will be the most severe in hospitals in New Jersey, New York, the District of Columbia, Arkansas, Kentucky, Mississippi, Illinois, and Massachusetts. Hospitals that treat the most low-income patients will be hit particularly hard.
A total of 278 hospitals nationally will lose the maximum amount allowed under the health care law—1% of their base Medicare payments. Several of those are top-ranked institutions, including Hackensack University Medical Center in New Jersey; North Shore University Hospital in Manhasset, New York; and Beth Israel Deaconess Medical Center in Boston, the article says.
The total number of hospitals receiving penalties is 2,211. According to Medicare records, 1,933 hospitals will receive penalties less than 1% percent. Massachusetts General Hospital in Boston, which has been rated as the best hospital in the country, will lose 0.5% of its Medicare payments because of its readmission rates.
Nearly 1 in 5 Medicare beneficiaries are readmitted within 30 days of discharge each year, costing Medicare 17.4 billion in additional hospital bills, according to a 2009 study on Medicare claims data from 2003-2004. The national average readmission rate has remained steady at slightly above 19%, even as many hospitals have worked to lower theirs, says Kaiser Health News.
Physical therapists can help serve an important role in patient care transitions and care coordination and can help reduce readmissions by providing recommendations for the most appropriate level of care to the health care team prior to and during care transitions. For more information and to find clinical practice and patient education resources to reduce readmissions, visit APTA's Hospital Readmissions webpage.