Public Policy

Penalties for Hospitals with Excessive Readmissions Take Effect


The new era of penalizing hospitals for higher-than-predicted 30-day avoidable readmissions rates has begun. Under the federal Hospital Readmissions Reduction Program, some calculate a hospital's excessive readmissions rate for each applicable condition.

Penalties for the current fiscal year—FY 2013, which began Oct. 1, 2012—will be based on discharges that occurred during the three-year period from July 1, 2008, to June 30, 2011, according to the program guidelines. For hospitals that don't improve, the penalty grows to a maximum 2% next year (FY14) and 3% in FY15.

Hospitalists are not penalized directly for readmissions, and many hospitalists are wondering about the extent to which they're responsible for a readmission after the patient leaves the hospital, notes Mark Williams, MD, FACP, MHM, chief of the division of hospital medicine at Northwestern University’s Feinberg School of Medicine in Chicago.

Dr. Williams is the principal investigator of SHM’s Project BOOST (Better Outcomes for Older Adults through Safe Transitions), one of several national quality initiatives that teach hospitals and other healthcare providers how to improve transitions of care through such techniques as patient coaching and community partnerships.

"These new penalties mean that hospitals will start talking to their physicians about readmissions, and looking for methods to incentivize the hospitalists to get involved in preventing them," Dr. Williams says.

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