Hospitals Face Penalites for Patient Readmissions

This fall, hospitals in Wisconsin and across the country will face penalties when Medicare patients dismissed from the hospital return because of complications. Wisconsin hospital officials say the numbers show the strategies to prevent patients from coming back are working.

About 70-percent of Wisconsin hospitals measured for readmission rates will avoid a penalty altogether, and no hospital will be fully penalized. Kelly Court is chief quality officer at the Wisconsin Hospital Association. She says the relatively few number of Medicare patients who return to the hospital because of complications is due to coordination. Medicare patients are at a high risk of returning to the hospital, so Court says discharged patient have to get good care from community doctors, home care agencies and nursing homes when they leave. “Hospitals can only do so much to prevent the readmission, like [making] sure patients understand their discharge instructions, understand their medications, make a good transition to a physician after the patient leaves the hospital. But once the patient leaves, the hospital has very little control.”

Wisconsin is trying a pilot project with 65 hospitals to reduce readmission rates for all patients, regardless of whether they’re on Medicare or not. Medicare reimbursement for hospitals is now tied to readmission rates for heart attack, congestive heart failure and pneumonia.

You can view the full list of hospitals and their Medicare readmission penalty rates (higher readmission rates mean more patients return with complications) at Kaiser Health News (pdf), along with their story, “Medicare To Penalize 2,211 Hospitals For Excess Readmissions.”

This report is part of a collaboration that includes WPR News, Kaiser Health News, and NPR.