Readmission fees and penalties article evaluate

Medicare And Medicaid, Older, Heart Failure, Heart Attack

Research from Content Critique:

Hospitals with more elderly, poor patients likely to face readmission penalties” by Katie Sullivan (January eight, 2014)

A few hospitals preventing powering patients just before they are prepared, causing them to be subsequently readmitted? This may seem to be the problem involved in the recent decision by the federal government to assess penalties if perhaps hospitals take care of so-called “dual-eligible seniors, ” or those eligible for medical care under both Medicare and Medicaid, mainly because these individuals are at greater risk of readmission within thirty days of release. According for an article by Sullivan (2014), the reality of the situation is that the majority of the hospitals which will be adversely impacting by this decision are these whose treatment area consists of inordinately larger percentages of senior citizens who have require a greater share of healthcare assets compared to their particular younger alternatives. Moreover, the quality of care becoming provided in these hospitals is usually not generally at concern. In this regard, Sullivan reports that, “Researchers discovered hospital top quality wasn’t generally to blame, nevertheless that the hospitals were in regions with fewer or perhaps lower quality primary proper care resources, raising the likelihood of someone getting readmitted within 40 days” (2014, para. 2).

Despite this lack of actual liability, the decision to charge these hospitals penalties can have some enormous financial consequences. Relating to Sullivan, “Those hospitals are more likely to have their [Centers for Treatment Medicaid Services] payments cut – up to 3% by 2015 – under the Hospital Readmission Reduction Program, which is designed to reduce the range of pneumonia, heart attack or cardiovascular system failure readmissions” (2014, afin de. 3). Even more troubling even now, the majority of the private hospitals that are the majority of adversely afflicted with this decision are those that are already monetarily strapped as a result of providing medical treatment for indigent health care customers who cannot pay for their very own services.

Some of the potential alternatives that are purportedly available to steer clear of this double-whammy penalty are nearly since laughable because the decision to implement such as policy on its own. For instance, Sullivan suggests that it will be possible in order to avoid the fees and penalties from the Centers for Medicare Medicaid Solutions if the federal government changes existing measures of quality to permit hospitals to report their readmissions in another way. Likewise, it would be possible to avoid the current double-whammy penalty simply by changing the way in which in which the Centers for Medicare insurance Medicaid Services authorizes payment for primary and