Large teaching hospitals and hospitals that primarily provide care to poor and uninsured patients are most likely to lose federal money under the U.S. government’s plan to improve quality by tying payments to readmissions, according to new research.
“The concern has been raised that when these penalties did come out, they would unfairly target the hospitals that treat the poorest and most complex patients,” said Dr. Karen Joynt, the study’s lead author from the Harvard School of Public Health in Boston.
As directed by 2010′s Affordable Care Act, the Centers for Medicare and Medicaid Services (CMS) – which oversees the federal health insurance programs for the elderly and poor – began tying hospital payments to the number of patients who returned for care within 30 days of their first discharge in October 2012.
If a hospital’s readmission rate is higher than CMS’s prediction, the agency is allowed to cut the hospital’s payments by up to 1 percent of their total Medicare reimbursement. That will increase to 3 percent by 2015.
For 2013, CMS estimates hospitals will lose – on average – 0.3 percent of their funding, about $270 million overall.
The concern, according to Joynt, is that these penalties may have serious implications for poorer hospitals that may not be able to absorb the funding loss.
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Source – Reuters