Legislation takes aim at socioeconomic factors behind hospital readmissions

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Medicare's hospital readmission penalties could see changes based on socioeconomic factors under a bill proposed in the House on Wednesday.

A provision of the “Helping Hospitals Improve Patient Care Act of 2016” aims to address concerns from rural and safety net hospitals, which provide care to low-income and vulnerable patients. Many of those hospitals said they were unfairly targeted by the Affordable Care Act's Hospital Readmissions Reduction Program due to “community health factors beyond their control,” Modern Healthcare reported.

Under the legislation readmissions penalties would be adjusted by comparing hospitals with similar populations of Medicare and Medicaid patients. Those adjustments would eventually change to a “more refined” method based on federal analysis required by the IMPACT Act.

The Helping Hospitals Improve Patient Care Act makes important changes that will allow hospitals to continue to provide high-quality care to patients as we implement recent payment reforms,” McDermott said in a press release.

The bill, sponsored by Health Subcommittee Chairman Pat Tiberi (R-OH) and Ranking Member Jim McDermott (D-WA), would also put a three-year freeze on the Centers for Medicare & Medicaid Services' ability to terminate Medicare Advantage contracts for plans that fail to achieve minimum quality ratings.

The legislation, which is fully paid by spending offsets, has been referred to the House Ways and Means and Energy and Commerce committees.