Dozens of Missouri hospitals are being penalized tens of millions of dollars by the Medicare programs because too many of their patients go back for more treatment within thirty days of their release.
The Centers for Medicare and Medicaid Services can fine hospitals one percent of their Medicare funds if their readmission rates are higher than average. The rates of seventy-six Missouri hospitals have been checked; fifty-three are being penalized for having excessive readmissions of patients treated for pneumonia, heart attack, or heart failure. Five hospitals are losing the full one percent.
The Medicare Payment Advisory Council says the three conditions highlighted this year represent the highest categories of patients hospitalized and later readmitted. It could recommend patients in other categories be included in the system in the next two years.
Missouri Hospital Association Vice President Dave Dillon says the penalty program will change the way hospitals provide care
AUDIO: Dillon :32
Dillon says the penalty system needs tweaking to make socioeconomic issues affecting former patients’ care part of the formula. Regardless, he says, community resources for those former patients need to be strengthened to make sure they follow post-hospitalization advice.
The Centers plan more Medicare payment reductions in each of the next two years for hospitals continuing to exceed the national readmission averages.
AUDIO: entire Dillon interview 12:36
Here’s a link to the list of Missouri hospitals affected by the program and the percentage of their Medicare funding they will lose this year. The table includes three columns of figures. The first one is the originally calculated penalty. The second column is a corrected amount. The third column reflects the changes made when the penalty amounts were revised. The second column is the one listing this year’s penalty amounts.