CMS Revises Medicare Readmission Penalties

For the second time in 6 months, the Centers for Medicare & Medicaid Services (CMS) officials have revised readmission penalties for hospitals. In doing so, approximately 1200 hospitals are now subject to lesser penalties.

The new corrections include decreased penalties for 1246 hospitals and increased penalties for 226 hospitals, resulting in a total of $280 million in penalties, which is approximately $10 million less than previously calculated. Kaiser Health News also released the following information following an analysis of the new data:

• Payments have changed, on average, 0.03% from the previously released penalties.
• Penalties for 329 hospitals that were changed in September have now been restored to the original level that was announced this past August.
• The largest penalty increase affects LaSalle General Hospital in Jena, LA; the penalty for that institution has risen from 0.65% to 0.84%.
• The maximum penalty will affect 31 fewer hospitals, and the total number of hospitals losing 1% of Medicare payments is now estimated to be 276, down from 307.

According to Jonathan Blum, Acting Principal Deputy Administrator and Director, Center for Medicare and CMS, stated that “This decrease is an early sign that our payment and delivery reforms are having an impact.” Kaiser Health News adds that “Under the program, the government is looking at the number of heart attack, heart failure, and pneumonia patients who return to the hospital within 30 days of discharge,” and that “hospitals with more readmissions than Medicare expected given their mix of patients are penalized by losing up to 1% of their regular payments.”

Around the Web

Medicare Revises Readmissions Penalties — Again [Kaiser Health News]

CMS Revises Hospitals' Readmission Penalties for the Second Time [Becker’s Hospital Review]