In a new effort to drive down the country’s high medical expenditures, hospitals with higher readmission rates now receive less monetary return on Federal Medicare, Medicaid money, beginning October 1, 2012.
The report calculated by Kaiser Health News, a non-profit organization shows a $280 million total of Medicare, Medicaid money docked from hospitals for high readmission rates, across the country.
Gordon Hospital experienced a 0.67 percent reduction of Medicare, Medicaid funds, of the estimated at risk $125,000 in federal medical aid that came through the hospital, according to Gordon Hospital’s Chief Medical Officer, Max Parrott.
“Right now, our admission rates are below what the federal government would expect our readmission rates to be,” said Parrott.
Kaiser Health News calculated numbers released by CMS, and compiled data from 2008-2010 to show each penalty for readmissions by hospital throughout the country from patients with heart failure, heart attack and pneumonia.
The rates will be effective for the next two years, docking one, two percent over the next two years, and a three percent cap in 2014, which according to Parrott provides medical providers throughout the country even more initiative to provide the best care to patients.
“For 2014 its (Gordon Hospital’s at risk dollars) right at $250,000 and then the next year, it is right at $400,000, so it gets more because the percentage gets higher,” said Parrott. “Not only that, but for the hospitals if your market share goes up, or the number of patients that come to your hospital, the more you’re running a risk, there is great incentive to make sure that we are doing the very absolute best we can do, above and beyond the fact that we are going to do that anyhow.”
The state of Georgia ranked 24th in the amount of money its hospitals will be penalized with 0.23 percent, Alabama came in 19th, and Tennessee was the ninth ranked state most penalized for hospital readmissions.
According to Kaiser, more than 2,000 hospitals nationwide will be penalized, and even some recognized nationally will be penalized.
Though Gordon Hospital’s 0.67 percent is not the lowest in the region, Parrott explains the percentage does not reflect a lesser quality of care patients receive at the hospital.
“It’s hard commenting on quality of care, when you look and see that Johns Hopkins and all these other places that had scores that were less than stellar, well I can promise you get pretty good care there, but the data is the data,” said Parrott.
The initiative with CMS does not relate to “Obamacare,” according to Parrott who says it is a difference between quality of care versus healthcare expansion, and Parrott also agrees it is a good thing for patients.
“The dollars are simply a way that folks who pay for the healthcare, want to make sure that we as the providers are doing everything we can to provide the standard of care, the best quality of care and making sure patients, that when they go home, they have all they need, and all of these things theoretically will decrease the healthcare expenditure for our country,” said Parrott. “On average you ought to be able to see if your hospital has got any deficiencies, is improving those, and that they consistently deliver the quality of care that you would expect, that the government and the payers would expect, and Gordon Hospital meets all of that.”
The release of the quality of care data for patients to determine which health care provider to choose is only the beginning, says Parrott who encourages patients to find out and understand completely the quality of care provided by each hospital.
“It’s going to be an interesting time in medicine. There is going to be more and more data of this kind coming out to patients to help make health care decisions, and I hope that data is clear enough for them to make the right decisions,” said Parrott.
For more information, visit medicare.gov, HHS.gov, or visit Kaiser Health News at http://www.kaiserhealthnews.org/Stories/2012/August/13/medicare-hospitals-readmissions-penalties.aspx to view the complete list of penalties by state.