Policy Options to Help Safety-Net Hospitals Reduce Readmissions
To encourage hospitals to reduce avoidable patient readmissions, Medicare now lowers payments to hospitals that have worse-than-average readmission rates for heart attack, heart failure, and pneumonia. According to a new <a href="/publications/issue-briefs/2012/dec/higher-readmissions-safety-net-hospitals-and-potential-policy">Commonwealth Fund analysis</a>, the rule, which took effect in October, will have a disproportionate impact on safety-net hospitals that provide care to large numbers of low-income Americans. <br /><br />
The analysis, prepared by Commonwealth Fund researchers Julia Berenson, M.Sc., and Anthony Shih, M.D., finds that safety-net hospitals—which include many public hospitals and teaching hospitals—are 30 percent more likely to have 30-day readmission rates above the national average, compared with other hospitals. The study is based on publicly available data for 2,200 facilities, and focuses on admissions for Medicare fee-for-service beneficiaries age 65 or older. <br />
<br />
Although the new penalties are capped—at 1 percent of the total amount a hospital would normally receive in Medicare payments for the year, increasing to 3 percent in 2015—many safety nets are already in a precarious financial situation. The authors say that policymakers can help by targeting quality improvement initiatives to these hospitals, ensuring that broader delivery system improvements involve safety-net hospitals and care delivery systems, and incentivizing improvements in care coordination and quality through "bundled payment" models that feature higher reimbursement levels for organizations caring for vulnerable populations. <br />
<br />
Read more on <a href="/publications/issue-briefs/2012/dec/higher-readmissions-safety-net-hospitals-and-potential-policy">commonwealthfund.org</a>. <br />
<br />