More penalties on the way for hospitals that treat the poor? New study suggests so

November 1, 2014, University of Michigan Health System

Last week, the federal government revealed that it will fine more than 2,600 hospitals in the coming year, because too many Medicare patients treated at these hospitals are ending up back in the hospital within 30 days of going home. Two new conditions have been added in this round of penalties: elective hip and knee replacement and chronic lung disease.

Now, a new University of Michigan analysis shows that penalties for will have a greater impact on hospitals that care for poor and . The findings are published in The American Journal of Respiratory and Critical Care Medicine.

Approximately one in five Medicare patients are rehospitalized within 30 days of discharge, a rate the Centers for Medicare & Medicaid Services (CMS) considers excessive.

Since 2012, CMS has reduced payments to hospitals with excessive readmission rates for patients with heart failure, heart attack, or pneumonia.

Now, CMS is also including readmissions for hip/ surgery and chronic obstructive pulmonary disease – also known as COPD – in their calculations of a 's penalties.

"We worry that this policy may cause more harm then good," says author Michael Sjoding, M.D., a pulmonary and critical care fellow in the U-M Medical School's Department of Internal Medicine. "Medicare is trying to improve patient care and reduce waste, but the hospitals they are penalizing may be the ones who need the most help to do so."

For the study, researchers evaluated three years of data on 3,018 hospitals that cared for patients with COPD. They found that, based on readmission rates in the past, teaching hospitals and safety-net hospitals will bear the brunt of the new financial penalties.

These hospitals often care for a larger number of poor or medically complex patients with COPD—who are at a higher risk for readmissions because of a large number of socioeconomic and health factors.

CMS's Hospital Readmission Reduction Program was designed to stimulate hospitals to improve the quality of care for select diagnoses by providing financial incentives to lower readmissions. But research shows many times patients get readmitted for reasons outside a hospital's control.

"If patients can't afford medications, or have unstable housing situation, they may end up being readmitted to the hospital," says Sjoding. "No interventions to date have effectively and sustainably reduced COPD readmissions, so it's unclear what a hospital can do to prevent them."

Prior studies found penalties for other conditions may also target hospitals caring for vulnerable patients. Experts have recommended that the policy should be changed, but whether Medicare will make any changes to address the issue is not clear.

Explore further: Hospitals serving elderly poor more likely to be penalized for readmissions

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4 comments

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Constitutionalist
1 / 5 (2) Nov 01, 2014
Yet another example of Progressive-ism run amuck.

The reason Medicaid patients are re-hospitalized more frequently is that the Fed's price fixing pays so little for their treatment. When treating Medicaid patients, low reimbursement rates force hospitals to cut corners. Many hospitals happily treat them at a loss as they feel it their obligation to treat the poor.

So what's the progressive solution to the problem they created? Fine the hospitals! Laughable. The reason for the recidivism is the Feds won't pay enough and the progressive solution is to make sure they make even less? All this policy will lead to is more and more hospitals refusing Medicaid.

It never stops. Progressives create problems through government intervention then blame the market to justify more intervention which in turn makes the situation even worse. It's a farcical at this point. This all leads to an already heard cry - "the market" cannot do this, we need government run healthcare.
carol_cross_71066
5 / 5 (3) Nov 01, 2014
The elderly/disabled/poor on Medicare/Medicaid have been targeted for savings in end-of-life care, i.e. hastened death, since 2006, at least! CMS reimbursement law and administrative rules approved by The Congress of the United States and the Executive in 2006 have been moving Medicare/Medicaid to "managed care" and "managed death" to protect the profits of private insurance who has invaded the people's social safety nets of Medicare/Medicaid to realize private profits.

How do you explain HOW some of the CEO's of public companies who provide Medicaid Insurance for the States earn millions of dollars in annual compensation because they make profits for their shareholders? The Center for Public Integrity reported on these "obscene" profits but the free press has been corporatized and there is no money to be made in telling the truth about all of the fraud and corruption to the American people. We've been HAD!

Viva La Madre
5 / 5 (2) Nov 01, 2014
Don't you think it's twisting the real issue here by implying hospitals are being fined for treating the poor? Because that is exactly what the title alone sounds like. It's about treating the poor but not doing a very good job at it since many are being readmitted for the same thing again. Treat them like you would someone who has a company provided healthcare plan and the readmittance would most likely be reduced greatly. Then it would be overlooked because the numbers would be smaller. Yes, some have to be readmitted. But do so many have to be? My guess would be no, not that many. Which is why they are being fined. It's going on al over the nation. for profit medical facilities, doctors, drug companies, etc. are all making healthcare more difficult to get and more costly. All in hopes that we the people will blame"Obamacare". I for one blame the greed in the medical industry for hurting people for profits. Not the ACA.
cruisepuppy7452a
not rated yet Nov 02, 2014
They want the poor, old, and disabled to die. Simple as that, they just don't give a damn about them. Doctors can't treat them as they need to, are told do the basics and if they die, eh, its not on us. Is that what we have become, a nation that forces doctors to pick and choose based on patient monetary worth? Really? Am I living in the US or Nazi Germany? If Cuba can treat all people for pennies on the dollar, regardless of fiscal wealth,, what is wrong with the US? Government should not be allowed to dictate who lives and dies, Doctors who studied, paid out the behind for med school should be allowed to practice, treat all people, the first time, get it right. That is how you save money, lives, and preserve the rights and liberties of all. Letting insurance companies, lawyers, and greedy politicos getting kickbacks is the cancer we must remove to fix this problem once and for all. If not, You are no better than the Nazis.

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