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MedPAC May Look at Readmissions Policy

The new federal policy that penalizes hospitals for “excessive” readmissions of Medicare patients may need reconsideration.

Or so believes MedPAC, the independent federal agency that advises Congress on Medicare payment issues.

Under a program launched in 2010 but that began affecting hospitals last October, Medicare assesses financial penalties against hospitals that have what it believes to be “excessive” readmissions of patients suffering from a limited group of medical problems.  The penalties, up to one percent of hospitals’ base Medicare payments, will eventually rise to two percent of those payments.  Since the program’s introduction, many hospitals have successfully reduced their readmission rates.

But now MedPAC is concerned about the program’s one-size-fits-all impact on hospitals.  At its recent public meeting its staff noted that the socioeconomic status of a hospital’s patients may affect readmission rates and that low-income patients may have limited access to needed services upon discharge  – and therefore may be more likely to require readmission to facilitate their recovery.

The National Association of Urban Hospitals (NAUH) 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 MedPAC’s perspective on Medicare’s hospital readmissions reduction program and how it might be improved in this CQ HealthBeat article presented by the Commonwealth Fund.medpac-logo.Par.0001.Image

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