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Over 2000 Hospitals to be Penalized for High Readmission Rates

According to a report from Kaiser Health News, more than 2,000 hospitals — including some nationally recognized ones — will be penalized by the government starting in October because many of their patients are readmitted soon after discharge, new records show.

Together, these hospitals will forfeit about $280 million in Medicare funds over the next year as the government begins a wide-ranging push to start paying health care providers based on the quality of care they provide.

Here are some key points from this report:

  • Nearly 2 million Medicare beneficiaries are readmitted within 30 days of release each year, costing Medicare $17.5 billion in additional hospital bills.
  • A total of 278 hospitals nationally will lose the maximum amount allowed under the health care law: 1 percent of their base Medicare reimbursements.
  • 1,933 hospitals will receive penalties less than 1 percent.
  • Massachusetts General Hospital in Boston, which U.S. News last month ranked as the best hospital in the country, will lose 0.5 percent of its Medicare payments because of its readmission rates, the records show.
  •  The smallest penalties are one hundredth of a percent, which 50 hospitals will receive.
  •  The penalty will be deducted from reimbursements each time a hospital submits a claim starting Oct. 1. As an example, if a hospital received the maximum penalty of 1 percent and it submitted a claim for $20,000 for a stay, Medicare would reimburse it $19,800.
  • 1,156 hospitals where Medicare determined the readmission rates were acceptable will not lose any money.

Where do your local hospitals fall in this list?  What can you do to help them reduce readmissions?  This data may be helpful to you in preparing your next presentation to the C-Suite officers at your local referring hospitals.

What has been your experience in having conversations with your local hospitals about reducing readmissions?  What results have you achieved in developing strategic alliances with them?  We’d love to hear your comments.

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