Noteworthy News

New Medicare Program Readmitted for Additional Work

Medicare’s new hospital readmissions reduction program has itself been readmitted for extra work after the federal government concluded that faulty calculations have resulted in inaccurate penalties and payments.

The Centers for Medicare & Medicaid Services (CMS) has announced that as part of a recent reexamination of hospitals’ performance under the program, more than 1200 hospitals were overpenalized and more than 200 will have to pay larger penalties than they were originally assessed.

The readmissions reduction program is being credited with a decrease in Medicare hospital readmissions across the country.  At the same time, however, a report in the New England Journal of Medicine suggested that the program will penalize hospitals that care for especially poor and sick patients.  MedPAC, the independent federal agency that advises Congress on Medicare reimbursement issues, recently expressed similar concerns.

These views echo those of the National Association of Urban Hospitals (NAUH), which has long argued against the Medicare penalties for readmissions, maintaining that the patients urban safety-net hospitals serve are typically sicker and more difficult to treat than the average hospital patient.  Such patients also generally have a more difficult time gaining access to the family, community, and medical support services they need to avoid readmission to the hospital.  NAUH’s argument against Medicare’s readmissions reduction program can be found here, in the association’s June 25, 2012 letter to the Centers for Medicare & Medicaid Services titled “Proposed Changes in Medicare Inpatient Payment Policies.”

Read more about the technical problems the program has encountered, the successes for which it is being credited, and the concerns that some people still have about it in this Kaiser Health News reportMedical Equipment.

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