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What We're Reading: More Than Half of Hospitals Will Be Penalized for Readmissions

AJMC Staff
What we're reading, August 3, 2016: Medicare penalties for hospital readmissions reach a new high; the importance of down-ballot races this election; and Virginia's Bureau of Insurance comes out against the Anthem-Cigna merger.
Medicare will withhold more than half a billion dollars in the next year for hospital readmissions. According to Kaiser Health News, the penalties represent a new high as more than half of the hospitals in the United States reported that more patients than expected returned within 30 days of discharge. The $528 million in penalties is $108 million more than last year’s total penalties. The reason: changes in how readmissions are measured.

In a blog post for The Wall Street Journal, Kaiser Family Foundation’s Drew Altman explains by down-ballet races will matter this election. He pointed to Louisiana and Kentucky, 2 states that recently reversed their positions on expanding Medicaid after new governors were elected. Louisiana’s John Bel Edwards succeeded Bobby Jindal, who had been very opposed to Medicaid expansion. Meanwhile, in Kentucky, Matt Bevin has promised to undo the work of his predecessor, Steve Beshear, who set up one of the most effective state insurance marketplaces. This election year there are 12 gubernatorial races, 3 of which are in states that have not yet expanded Medicaid.

The Department of Justice has filed a lawsuit against Anthem and Cigna for their proposed merger, and another state is saying the deal would hurt consumers. Virginia’s Bureau of Insurance says the merger would be a bad deal for consumers in the state, reported The Washington Post. Anthem is the largest insurer in Virginia and covers more than 22% of the market. Virginia’s state attorney general is among those suing alongside the Department of Justice to block the proposed merger.

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