The U.S. government’s federal insurance program is 2 months away from financially clobbering half of the hospitals in the nation. Medicare reports they intend to withhold more than half a billion dollars over the next 12 months. The fines address readmission penalties of 2,600 hospitals.
As mandated by the Affordable Care Act, these penalties will go into place this October 1st.. They are based on patient re-hospitalization incidents after patients were discharged with 6 different health conditions.* The purpose of the penalties is to pressure hospitals to better track when patients are discharged, and to pay closer attention to how patients do after they go home.
Medicare reports the fines will total $528,000,000 – 20% higher than last year.
The penalties are based on a Medicare patient analysis of those who were discharged between July 2012-June 2015. For each hospital, the study estimated how many readmissions would be normal, given national rates and the health of the patients. Hospitals with more readmissions than expected will receive lower Medicare reimbursement the following fiscal year that ends September, 2017.
The study reports 1,621 hospitals have been penalized in each of the 5 years of the program.
*Medicare examined these conditions: heart attacks, heart failure, pneumonia, chronic lung disease, hip and knee replacements and heart bypass surgery.