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Readmissions to penalize most hospitals

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Modern Healthcare analysis  has led it to report that “most  U.S. hospitals will get less money from Medicare in fiscal 2016 because too many patients return within 30 days of discharge.”

It reports that “Only 799 out of more than 3,400 hospitals subject to the Hospital Readmissions Reduction Program performed well enough on CMS’ {the Centers for Medicare & Medicaid Services] 30-day readmission program to face no penalty. Thirty-eight hospitals will be subject to the maximum 3 percent reduction.”

“The readmissions program initially evaluated how often patients treated for heart attack, heart failure and pneumonia had to return to the hospital within 30 days of discharge.”

Last Friday the CMS issued final rules for Medicare’s hospital inpatient prospective payment system, including changes for  inpatient-care quality reporting, excess readmissions, hospital-acquired conditions and value-based purchasing programs.

“Modern Healthcare said that “Among those provisions is a major change to the readmission measure for pneumonia in fiscal 2017. The change expands the population cohort included in the analysis to patients with a principal discharge diagnosis of either sepsis or respiratory failure who also have a secondary diagnosis of pneumonia present on admission.”

“The hospital readmission reduction program has faced increasing criticism by health policy researchers and industry groups representing U.S. hospitals. They argue that many factors affecting whether a patient needs to be readmitted are beyond a hospital’s control. In particular, facilities in poor communities may be unfairly penalized, some of the program’s critics say. ”

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