In a bit of good news for hospital patients in North Carolina, the federal government’s new reimbursement procedures may help to force doctors to provide better care. New Medicare regulations that began at the end of last year are designed to reduce payments to those hospitals with higher-than-expected readmission rates for heart failure, heart attack and pneumonia. The penalties could be big enough to cost some hospitals millions of dollars and will likely send a clear message to physicians that caring for patients properly the first time around is of the utmost importance.
Though the penalties only apply to a limited set of conditions, this is expected to change to include several other serious health conditions. Hospitals will then have a real incentive to work hard to reduce the number of patients who have to return soon after a discharge, a widespread problem that has yet to be properly addressed.
Experts in the medical field suggest a lack of coordination among healthcare providers is to blame for the high rate of readmissions. Hospitals often fail to identify which patients are at a high risk for complications, which leads to large numbers returning for further medical treatment. Minimal help for patients who have to make the transition from hospital to home is also to blame.
These hospital readmissions are not only costly in terms of unnecessary pain and even death for innocent patients, but financially costly as well. The Center of Medicare and Medicaid Services (CMS) estimates that such readmissions cost the government nearly $26 billion a year. The CMS has said that hospitals need to implement better discharge planning, more home-based follow-up procedures and provide quality patient education.
A recently released study out of Yale University that tracked some four million patients found that nearly 20% were back in the hospital within 30 days of their initial release. A separate study that followed three million Medicare patients between 2007 and 2009 found that 25% of patients with heart failure, 20% of heart attack patients and 18% of those with pneumonia were readmitted within a month of their original release date.
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