CMS: Readmit penalties will be higher than first thought

Share this article:
Consumer advocates renew call for portable bed rail ban after deaths lead to recall
Consumer advocates renew call for portable bed rail ban after deaths lead to recall

A miscalculation by the Centers for Medicare & Medicaid Services means that more than 1,400 hospitals with comparatively high readmissions rates will lose more federal funding than previously thought, the agency revealed in October.

While the additional reimbursement losses are not expected to be huge, the announcement raised already high anxiety levels among hospital and long-term care providers to new levels.

The largest penalty increase was from 0.62% to 0.73% of Medicare reimbursements, a Kaiser Health News analysis showed. Overall, 1,422 hospitals will lose more funding than previously expected while 55 will lose less than first thought.

Oct. 1 marked the start of a new CMS policy that withholds up to 1% of a hospital's Medicare funding, based on 30-day readmission rates. The potential penalties will double next year and triple the year after.

That has created a quality “race” among post-acute care providers, including long-term care operators. Hospitals will want to partner only with other providers that have demonstrated a record of good care outcomes — and low rehospitalization rates.

CMS's miscalculation occurred when it inadvertently considered Medicare claims info from before July 1, 2008, officials said. The assessment period was supposed to be only from July 2008 through June 2011.

The correction was “disconcerting, particularly with a policy that's bad to begin with,” said Atul Grover, M.D., Ph.D., a medical college lobbyist quoted by Kaiser.

Long-term care providers have focused on improving to become better partners. The American Health Care Association notably has set a goal of cutting rehospitalizations within 30 days by 15% by March 2015. 


Share this article:

More in News

Expert says providers often wrongly threatened by PEPPER reports

Instead of fearing further scrutiny by federal authorities, providers should embrace the opportunity to get feedback in the form of PEPPER reports, legal experts said Monday at the LeadingAge annual meeting in Nashville.

Healthcare reform already driving diverse, dynamic long-term care models, LeadingAge leaders say

Healthcare reform already driving diverse, dynamic long-term care ...

One way to gauge the effects is healthcare reform is by looking at ongoing changes to the continuing care retirement community model, LeadingAge officials said Monday at the association's annual ...

Federal court: Nursing home can be sued for firing hairdresser who can ...

Is the ability to transport residents in their wheelchairs an essential function of a nursing home hairdresser? A federal appeals court says it's a valid question and is allowing a hairdresser to sue a facility that fired her.