This is the first year of the readmission program, which considers readmissions from AMI, heart failure and pneumonia. Hospitals that do not curb high readmission rates face a maximum 1 percent cut from base Medicare reimbursements. Starting in October 2013, the maximum penalty will increase to 2 percent of base Medicare reimbursements, and it will be capped at 3 percent in October 2014.
The MedPAC report reveals the following key points:
Readmission rates
• Overall readmissions have fallen over the last three years.
• All-cause readmissions fell from 15.6 percent in 2009, to 15.5 percent in 2010 and 15.3 percent in 2011.
Readmission factors
• There is greater variation in 2011 readmission rates by race and income.
• There is limited variation in readmission rates across hospital types.
Readmission penalties
• Of the 67 percent of hospitals that will be penalized, 9 percent will face the penalty cap.
• The remaining 33 percent of hospitals have no penalty. Of these, 6 percent will not be penalized because they do not have enough cases.
• The average penalty for hospitals will be approximately $125,000.
• In aggregate, the penalties will total approximately 0.24 percent of total inpatient hospital payments in 2013.
MedPAC also discussed four long-term issues with the readmissions reduction program:
1. Computation of the penalty multiplier
2. Random variation and small numbers of observations
3. Unrelated and planned readmissions
4. Socioeconomic status and risk adjustment
More Articles on Readmissions:
Hospital and Health System Strategy in 2012: 6 Key Initiatives
Healthcare Data Guides Tri-City Medical Center’s Decisions in Quest for Top Quality
Leveraging Technology to Collaborate With the Community on Reducing Readmissions
