The program, which is scheduled to begin in fiscal year 2012, would reduce Medicare reimbursements to hospitals with high levels of preventable readmissions starting with three high volume conditions: acute myocardial infarction, heart failure and pneumonia.
HFMA said it the letter it was concerned over a lack of demographic factors in the risk adjustment methodology, which could “further disadvantage safety net hospitals,” according to an HFMA report.
HFMA also recommended that CMS:
• Reevaluate its list of excludable readmissions and exclude readmissions related to random events, such as motor vehicle accidents.
• Increase the proposed rule’s minimum threshold of 25 discharges for each condition as the minimum number needed to be included in the program.
• Provide hospitals with their expected readmissions ratio and actual readmissions counts on a quarterly basis.
• Take into account factors outside a hospital’s control when calculating readmission rates for all patients.
Read the HFMA report on the Hospital Readmissions Reduction Program.
Related Articles on Avoidable Hospital Readmissions:
Texas Hospital Exceeds CMS Goal for Reducing Hospital Readmissions
AHA Urges CMS to Include Additional Patient Characteristics in its Hospital Readmissions Program
