AHA Rejects Proposed Readmission Penalties

Cheryl Clark, for HealthLeaders Media , June 25, 2012

Federal officials "ignored Congress's intent" when it wrote its proposed rules governing how hospitals will be penalized up to 1% for higher readmission rates, said American Hospital Association executive vice president Rick Pollack.

That's in part because the May 11 document by the Centers for Medicare & Medicaid Services does not exclude all planned and unrelated readmissions from being counted against the 3,393 hospitals affected by the penalty rule, which will take effect Oct. 1, the AHA says.

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Additionally, the formula CMS proposes is viewed as discriminatory against hospitals with higher percentage of non-white patients, higher percentages of so-called dually-eligible patients who are covered by both Medicaid and Medicare.

And, hospitals contend, it places at a disadvantage those hospitals that receive disproportionate share funding, called DSH facilities, because they have more underinsured and uninsured patients. Pollack said that readmissions among such patient populations are "beyond (the) hospitals' control."

Pollack made his remarks to CMS last week in a 62-page letter that included objections to several other parts of the proposed Inpatient Prospective Payment System rule, for which the comment period ends Monday, June 25. 
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1 comments on "AHA Rejects Proposed Readmission Penalties"

Tom Johnson (6/25/2012 at 8:30 PM)
Rick Pollack is right on target with his criticisms of this CMS readmission penalty rule. Study after study have pointed out that patients in the lower socio-economic rung tend to have more co-mobidities; they tend to have less access to health care information; they often don't have access to primary care services; they don't have the same level of compliance to accepted health care guidelines for self care, etc. Their re-admission rate is bound to be higher and many of these patients are under Medicaid or are uninsured so hospitals taking care of a disproportionate share of these patients will be unfairly penalized. This CMS rule is a utopian rule not grounded in reality. Tom Johnson, LFACHE




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