Hospitals Try To Control Readmissions, Even When It Hurts Profits

The U.S. Department of Health and Human Services is taking hospitals’ repeat customers very seriously. Almost 1out of 5 Medicare patients discharged from a hospital is back within 30 days. Research suggests as many as 75% of those return visits could be prevented with better treatment in the hospital and better care once people are back home.

As with many other problems in the healthcare system, unnecessary hospital readmissions are associated with worse treatment and health outcomes, as well as higher costs to taxpayers — $15 billion a year for Medicare alone, according to a Medicare Payment Advisory Commission study.

Starting next fall, HHS will begin penalizing hospitals if their readmission rates are higher than expected for 3 conditions: heart attacks, heart failure and pneumonia. In the first year that penalties kick in, 1% of hospitals’ Medicare payments will be withheld, and that penalty will climb in subsequent years — at a time when payers are reducing fees to hospitals on a number of other fronts, too.

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Sources: Kaiser Health News; NPR; WNYC