By Richard Asinof
WASHINGTON - More than 2,000 hospitals nationwide will be penalized by the government starting in October because many of their patients are re-admitted soon after discharge, according to a report published Aug. 13 by Kaiser Health News. Together, these hospitals will lose about $280 million in Medicare funds.
About one in five Medicare patients return to the hospital within a month of discharge, according to the Centers for Medicare & Medicaid Services. As a result, the federal government considers hospital re-admissions to be a prime target of its efforts to control costs.
In Rhode Island, nine hospitals will be penalized a total of $1.6 million in Medicare funds, for Funding Year 2013, out of about a total of $600 million in Medicare funds, according to Edward J. Quinlan, president of the Hospital Association of Rhode Island.
The penalties for hospitals are as follows:
Westerly Hospital and Women & Infants Hospital incurred no penalties.
Quinlan said that while the issues of hospital re-admissions and penalties were important, he hoped that CMS would change its methodology and establish an accountability of care for the continuum of care. “Hospitals are now held accountable for any break in that continuum,” he said. “Any break in the discharge planning for patients [could cause a re-admission], but only the hospitals are now being penalized.”
Quinlan cited the work being done by Healthcentric Advisors to reduce unnecessary hospital re-admissions in Rhode Island through a pilot program of coaching patients and family members. The penalties, however, will not change for the upcoming year. “This is Medicare. Medicare pays you what they tell you, what they say they will. There are no contract negotiations,” he said.
Lifespan spokeswoman Gail Carvelli said that the hospital group “is continually focused on quality and safety measures across the organization, placing a strong emphasis on reducing re-admissions.”
“We are also focused on other measures that the federal government is using as part of its pay-for-performance quality efforts, all with the goal of improving quality and safety across the board,” she said.