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A better way for handling readmissions penalties for safety-net hospitals

The recently enacted Cures Act has what sounds like a better way for dealing with hospital-readmission penalties for safety-net hospitals..

A blog entry in Health Affairs notes: “The Hospital Readmissions Reduction Program (HRRP), authorized by the Affordable Care Act, aims to improve care and outcomes for patients by assessing hospitals’ risk-standardized readmission rates. Hospitals that do not meet the readmission standard receive a penalty of up to 3 percent of their Medicare payments. Before the program’s inception, hospitals and academics raised concerns that readmissions penalties would have disproportionate impact on safety-net hospitals and might lead to worsening disparities. And, in fact, studies have shown that safety-net hospitals were more likely to be penalized than non-safety-net hospitals in the first years of the program.”

But, the article says, the Cures Act “changes this by instructing HHS to set different penalty thresholds for hospitals, based on the portion of Medicare-Medicaid dual eligible patients that are served by a hospital. What is critical to note is that this law—in contrast to prior proposals, which argued for changes to the readmission measures—directly mitigates the impact of penalties on safety-net hospitals.”

To read the Health Affairs piece, please hit this link.

Will Cures Act level playing field on readmissions penalties?


Modern Healthcare reports:

“Nestled within the 994 pages of the 21st Century Cures Act …   is an opportunity for hospitals to change the way they are judged when patients are unnecessarily readmitted.

“The law requires Medicare to account for patient backgrounds when it calculates reductions in its payments to hospitals under the Hospital Readmissions Reduction Program.

“Until the passage of the Cures Act, originally meant for biomedical innovation but turned into a smorgasbord of healthcare policies, thorny questions about adjusting for patient demographics had been avoided.

“Hospitals have been at fault if, within 30 days after discharge, patients return to the hospital for the same reason they were originally admitted. But some hospitals are located in impoverished areas, and many of their patients cannot afford to buy medication or healthy food, or they lack transportation to attend checkups with primary-care doctors.

“Nevertheless, unless a hospital’s readmission rate falls below the national average, it will face financial penalties under the program.

“Hospital and medical groups hope the 21st Century Cures Act will ensure funds are not unduly taken from hospitals that need it most. Policy experts, however, say that the effectiveness of risk adjustment depends on the details of its implementation, which are scant in the legislation.’

To read the whole piece, please hit this link.

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