Medicare to Punish Hospitals for Excess Readmissions

Medicare, under the new healthcare legislation,is taking steps to crack down on excessive readmissions with the goals of increasing quality of care, reducing costs and minimizing the number of trips back to the hospital patients will have to make.

According to an article by Jordan Rau in Kaiser Health News, Medicare has identified 2,225 hospitals that will have their Medicare payments reduced by up to 1 percent as a result of the fines imposed under the penalty provisions of the current Patient Protection and Affordable Care Act (PPACA) this year. Eighteen hospitals will lose 2 percent, the maximum penalty allowed under the new legislation for one year starting on October 1, 2013. The penalty program, which began one year ago, is designed to pay hospitals for the quality of their performance, not simply the number of patients they treat.

The program this year started by punishing hospitals for unplanned patient readmissions within 30 days after initial treatment for those treated and released for heart attacks, heart failure and pneumonia.

Based upon the first year’s results some large hospitals may lose more than $1 million in penalties. Also, hospitals that avoided the penalties may have even lost more in revenue due to their reduced admissions. Obviously, the hospitals are not too happy about this plan, especially those hospitals that treat large numbers of lower income patients. Low-income patients have a harder time following their post discharge instructions due to the cost of buying expensive medications, not fully understanding discharge instructions, or having the means to support a particular diet to avoid congestive heart failure.

Hospitals have taken additional steps, such as hiring more staff to follow up with patients outside the hospital to avoid these readmissions or giving them free medication upon discharge, as Medicare does not pay for these services. When one looks at this picture it just begs the question: why wouldn’t hospitals be more receptive to adding alternative therapies – such as EECP® Therapy – to their services so that they could also realize the same significant reduction in hospital readmissions that have been demonstrated in clinical studies, such as one authored by  Dr. Ozlem Soran at the University of Pittsburgh?

EECP Therapy is a proven treatment that will reduce hospital re-admissions. Now we need to persuade hospitals to jump on the EECP Therapy bandwagon by adding EECP Therapy services in their clinical departments or hospital owned physician practices.