HFMA Cites Several "Areas of Concern" in CMS' Readmissions Reduction Program

The Healthcare Financial Management Association has listed several "areas of concern" in CMS' Hospital Readmissions Reduction Program in a letter to the Agency.

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

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