CMS penalized more than half of hospitals participating in its Hospital Readmissions Reduction Program (HRRP) from fiscal year 2013 to 2017, according to a recent Health Affairs study. The average penalty increased from 0.29% in 2013 to 0.6% in 2017. Health Affairs referred to this as a modest penalty, bearing in mind that opportunities for penalization have increased since 2013.
Nancy is a manager of a hospital with a large indigent population. Nancy notes that immediately after the implementation of healthcare reform, many of her patients have obtained some form of health insurance, usually Medicaid. Often, the patients access Medicaid with the help of the hospital’s expert financial counselors. Recently, however, the number of uninsured patients in the community seems to be increasing. As a result, more uninsured patients are being admitted. Before healthcare reform, many uninsured people failed to seek timely, preventive healthcare. Therefore, they were quite sick by the time they came to a hospital. Nancy is now seeing a resurgence of uninsured indigent patients.
A recent study revealed good news for hospitals taking advantage of one or more Medicare value-based reforms. Participation in Medicare programs that focus on improving quality and value of care can often lead to a larger reduction in 30-day readmissions, according to JAMA Internal Medicine.
