Hospital Quality Improvement Takes Serious Tone with Looming Medicare Penalties

Kaiser Health reported that, beginning in October, 2211 hospitals will be financially penalized for their high volume of patient readmission rates. The Centers for Medicare and Medicaid Services (CMS) indicates the penalty rates will begin at 1 percent ($280 million total) this year, but will climb to 2 percent in 2013 and 3 percent in 2014; penalties will affect all types of hospitals, from safety-net to top ranked. 

Based on a report from the CMS, nearly 2 million Medicare patients are readmitted within 30 days of release, a statistic that is contributing to what the Government calls an “overly expensive and uncoordinated” healthcare system. The CMS reports that the high volume of readmitted patients adds an additional $17.5 billion to hospital bills every year.

The penalties are part of a Medicare effort to enforce hospital improvement; along with the penalties, there will also be rewards for hospitals that demonstrate improved quality care. According to Kaiser, hospitals have complained that Medicare is more stringent with readmission and hospital improvement than Congress intended; hospitals feel it is unfair to be held accountable for readmitted patients no matter the reason they return.

Kaiser reported that the intent of the penalties, and the rewards, is to make it clear just how severe the readmission problem is and to encourage hospitals to take action toward improving it. Dr. Eric Coleman, a national expert on readmission at the University Of Colorado School Of Medicine, does not believe that penalties alone will solve the problem, but agrees that the threat has prompted awareness.

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