The most severe financial penalties in 2012-13 consist of 1% Medicare payment cuts. The penalties will grow in coming years—a situation that alarms some critics because research shows that more cash-strapped hospitals treating populations with high rates of chronic illnesses are being hit the hardest by readmissions penalties.
“Safety net hospitals are much more likely to be penalized,” said Dr. Ashish Jha, a professor of health policy at Harvard School of Public Health.
A comprehensive study of six years of Medicare data, published last week in the online journal Medicare & Medicaid Research Review, concluded that 18.4% of all Medicare inpatients were readmitted for care within 30 days of discharge. That was a decline from the previous average rate of 19%, which was stable over the five preceding years.
The change meant that roughly 70,000 fewer readmission cases were seen in hospital wards in 2012 than would have been predicted by historical rates. The study found wide variation among regions in changes in readmission rates. But the authors wrote that comparing differences in the data was difficult because the data were not adjusted for differences in local disease profiles and demographic factors. Still, larger hospitals in all regions of the country tended to have higher rates of readmissions.
“It's kind of exciting to start to see the results tabulated on what direction we're headed,” said Matthew Press, an assistant professor of public health and medicine at Weill Cornell Medical College in New York. “But closer monitoring and analysis needs to happen to figure out how and why these readmissions were averted.”