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Medicare Begins Penalizing Hospitals For Readmissions

Medicare will begin penalizing hospitals Monday that have too many repeat patients who check back in due to complications. The penalties will come out of Medicare’s payments to the hospitals, and they're part of President Obama's health care law. 

Nearly one out of every five Medicare patients who walks into a hospital today will be back in the hospital within a month. That’s according to the Centers for Medicare and Medicaid Services, and improving that ratio is what the penalties are all about.

The government estimates more than 2,000 hospitals will be fined, although in many cases it’ll be a tiny part of the hospital’s Medicare budget.

That’s true at UNC Hospitals. But Chief Operating Officer Brian Goldstein said the penalties will have more of an impact than the money suggests, and for good.

"One big thing that this program is forcing all hospitals to do is to do a better job of coordinating with physicians and community care agencies to not only prevent readmissions, but also in some cases when it's good for the patient to try to prevent an admission in the first place," Goldstein said.

He sees that opportunity to improve coordination as the best thing about the new policy.

Stephen Wallenhaupt is the Chief Medical Officer at Novant Health. He says three of the four Presbyterian Hospitals in the Charlotte area won’t face penalties.

"That doesn’t mean we don’t continue diligently to make improvements to help these patients, to improve our care both on the inpatient side and the outpatient side," Wallenhaupt said.

Those changes should also save taxpayers money. Hospital readmissions cost Medicare more than $26 billion a year, according to the Centers for Medicare and Medicaid Services.  

If you want to see how other local hospitals fare with readmissions, you can find that information on Medicare’s “Hospital Compare” website.