KHN: January 2020: New Round of Medicare Readmission and Hospital-Acquired Conditions Penalties Hits 2,583 Hospitals…. Look Up Your Hospital: Is It Being Penalized By Medicare?

Readmission Rates and Hospital Acquired Infections clearly show the healthcare consumer which hospitals have good or bad medical practices.  The following, published by Kaiser Health News. helps the consumer look up their hospital and find out if they were fined.

Medicare cut payments to 2,583 hospitals , continuing the Affordable Care Act’s eight-year campaign to financially pressure hospitals into reducing the number of patients who return for a second stay within a month.

The severity and broad application of the penalties, which Medicare estimates will cost hospitals $563 million over a year, follows the trend of the past few years. Of the 3,129 general hospitals evaluated in the Hospital Readmission Reduction Program, 83% received a penalty, which will be deducted from each payment for a Medicare patient stay over the fiscal year that begins October 1

The average penalty will be a 0.71% decrease in payment for each Medicare patient who leaves the hospital over the next year, according to a Kaiser Health News analysis. The KHN analysis also found:

  • 1,177 hospitals received a higher penalty than they did last year.
  • 1,148 hospitals received a lower one than last year.
  • 64 hospitals received the same penalty as last year.
  • 194 hospitals that had not been penalized last year are being punished this year.
  • The maximum penalty — a 3% reduction in payments — was assessed against 56 hospitals.
  • 372 hospitals avoided penalties in both years.

These figures do not include 2,142 hospitals that Medicare exempted from the program this year, either because they had too few cases to judge; were veterans hospitals, children’s hospitals, psychiatric hospitals or were critical-access hospitals, which are the only hospitals within reach of some patients.

Under programs set up by the Affordable Care Act, the federal government cuts payments to hospitals that have high rates of readmissions and those with the highest numbers of infections and patient injuries. For the readmission penalties, Medicare cuts as much as 3 percent for each patient, although the average is generally much lower. The patient safety penalties cost hospitals 1 percent of Medicare payments over the federal fiscal year, which runs from October through September. Maryland hospitals are exempted from penalties because that state has a separate payment arrangement with Medicare.

Below are look-up tools for each type of penalty. You can search by hospital name or location, look at all hospitals in a particular state and sort penalties by year.

This Link will direct you to the Kaiser Health News tool.



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