Medicare will penalize 2,225 hospitals a total of $227 million because of readmissions rates, according to a report.
As reported by Kaiser Health News, the reduced payments will take effect Oct. 1 for the penalized hospitals. The maximum reduction of 2% per patient stay will be levied against 18 hospitals, with another 154 hospitals losing 1% or more.
The Centers for Medicare & Medicaid Services handed down the first round of penalties under the Hospital Readmissions Reduction Program, part of the Affordable Care Act, last October. The maximum penalty of 1% for the first year has increased to 2% for the new round of penalties and will go up to 3% next year. In all, 1,371 hospitals face a lower fine than last year and 1,074 face a higher fine, according to the report. Meanwhile, 1,154 hospitals avoided fines this year.
Among safety-net hospitals, which treat larger numbers of the poor and uninsured, 77% were penalized. Of hospitals with the fewest poor patients, by comparison, 36% were penalized. Kaiser Health News calculated that 87% of major teaching hospitals were penalized, compared with 63% of hospitals that do not train residents.
The penalties are based on readmissions of Medicare patients who originally were admitted for cardiac arrest, heart failure or pneumonia and were discharged between July 2009 and June 2012. Hospitals were fined if they had more unplanned readmissions of such patients than Medicare projected when considering the severity of patients illnesses.
Next year, in addition to facing a maximum 3% penalty, hospitals also will be evaluated on readmissions for bronchopulmonary dysplasia and knee and hip arthroplasty.
Read the report, which includes a link to a full list of hospitals that have been penalized: www.kaiserhealthnews.org/Stories/2013/August/02/readmission-penalties-medicare-hospitals-year-two.aspx.