Medicare punishes hospitals for high readmission rates

Columbus Dispatch

COLUMBUS

The government is docking more than 2,200 hospitals up to 1 percent of their Medicare money in the next year because too many patients end up back in a hospital weeks after discharge.

The penalties are part of a plan to encourage hospitals to work harder to lower readmissions through efforts that include better patient education and closer monitoring of the follow-up care patients get once they’re released.

Annually, about 2 million Medicare beneficiaries — 1 in 5 — are readmitted within a month of release at a cost of $17.5 billion. The national average readmission rate has stayed just above 19 percent for several years.

The payment cut at Ohio State University’s Wexner Medical Center is the highest in Columbus, at 0.64 percent, which amounts to about $700,000, or less than a tenth of 1 percent of the hospital’s revenue, said chief financial officer Michael Rutherford.

The reasons for readmissions are many and complex, said Dr. Blair Vermilion, the medical director of utilization management at Ohio State. They’re further complicated by the fact that a person who is released from a major medical center such as Ohio State might then be readmitted to a smaller center closer to home, something out of the original hospital’s control.

Aside from individual initiatives, hospitals have been working together through the Ohio Hospital Association to improve care and keep patients well once they leave the hospital, said John Palmer, the spokesman for the hospital group.

Nationally, Medicare is penalizing about two-thirds of the hospitals whose readmission rates it evaluated. The penalties fall heaviest on hospitals in New Jersey, New York, the District of Columbia, Arkansas and Kentucky.