Joe Mullany, CEO of the Detroit Medical Center, discusses how his system's Medicare Pioneer ACO has achieved successful results and the challenges and rewards of operating in economically troubled Detroit.
Until 2012, before the Affordable Care Act began cutting revenue, most tax-exempt hospitals in Southeast Michigan made profits on their Medicare business. Since then, reimbursement cuts, readmissions penalties and overpayment recoveries have eroded profits for many Detroit-area hospitals and health...
Regarding the recent article, “Readmissions may say more about patients than care”, I was the medical director at a hospital in Gary, Ind., brought in to turn around the emergency department, so I have seen underserved areas up close.
Hospital readmissions that Medicare penalizes under the Affordable Care Act are largely driven by patient characteristics such as income and education rather than the quality of care they receive, according to a new study.
Hospital readmission rates tracked with software widely used in U.S. hospitals generated confusing results. The study is the latest to add to the growing body of skepticism about the CMS' readmissions reduction program and the emerging technologies helping hospitals improve on the metric.
Healthcare delivery system changes continue to push patients away from inpatient care. That's suggested by a Modern Healthcare review of American Hospital Directory data, which found that the number of patient discharges fell 8.4% from 2013 to 2014.
Over the several years that the CMS and hospitals have been tussling over the reasons behind the steady rise in short-term observation stays, no one until now has suggested the increase represents a deliberate effort by hospitals to avoid Medicare's 30-day readmission penalties.
Just how much success have hospitals had in their efforts to prevent patients from returning soon after leaving? Perhaps not as much as reported, two physicians argue at the blog for health policy journal Health Affairs.
Four years into Medicare's drive to cut the number of patients who land back in the hospital within a few weeks of leaving, only a quarter of more than 3,400 hospitals avoided penalties, contributing to skepticism about the program and the array of metrics used to evaluate healthcare quality.
It doesn't matter how much healthcare providers and researchers rail about the inadequacy and inconsistency of the consumer ratings offered by the CMS, the Leapfrog Group, journalism outfits and online startups. They are not only here to stay, they are proliferating.
Most hospitals will get less money from Medicare in fiscal 2016 because too many patients return within 30 days of discharge. Less than 25% of hospitals subject to the program targeting readmissions did well enough to escape the penalty.
Data Points for the week of July 27, 2015, covered the following topics: Patient safety, medical homes, health insurance exchanges, Medicaid, readmissions