Readmission penalties for hospitals are expected to increase significantly over the course of the next year, according to a new report from Kaiser Health News.
The penalties will hit more than half of the hospitals in the United States, withholding a total of $528 million in Medicare funding. The number of facilities to be penalized should be about the same as last year, but the average penalty amount will increase by one-fifth, Kaiser says.
The projected $108 million increase in total fines is expected to occur due to changes in how the federal government measures readmissions, according to the report.
The penalties for fiscal 2017 were calculated based on how many readmissions were expected for each hospital between July 2012 and June 2015, depending on national readmission rates and patients’ health.
A total of 2,597 hospitals had more patients than expected readmitted within 30 days of original discharge, triggering the penalties. Officials analyzed readmissions for conditions including hip and knee replacements, heart attacks, heart failure and pneumonia.
Increased pressure to reduce hospital readmissions will likely be felt by post-acute care providers, especially those involved in alternative payment models such as accountable care organizations and bundled payment programs that place financial risk on hospitals.
The stakes surrounding readmissions will be raised even further in 2018, with the enactment of a provision of the Protecting Access to Medicare Act that will penalize both hospitals and skilled nursing facilities for excessive rehospitalization rates. Providers can take some solace, however, in a recent report that found a “widespread” drop in the number of 30-day readmissions among nursing home residents.
