More hospitals will face readmissions penalties in 2024, a departure from the lower rates of reimbursement cuts providers saw last year, according to preliminary data released Thursday.
While the Centers for Medicare and Medicaid Services has resumed use of its pneumonia readmissions measure, which was excluded last year from its Hospital Readmissions Reduction Program, payment adjustments have not returned to pre-pandemic levels.
Related: One in four hospitals won't be charged readmissions penalties
The hospital readmissions performance period for fiscal year 2024 still excludes data from the first half of 2020, pulling claims from July 2019 to December 2019 and from July 2020 to June 2022. The penalties also exclude data from hospitals with approved extraordinary circumstance exceptions.
“It's probably going to be a messy couple of years,” said Akin Demehin, senior director for quality and patient safety policy at the American Hospital Association. “The ways in which COVID-19 interacts with quality performance on things like readmissions will take time to settle out completely.”
Higher rates of penalties for hospitals likely reflect their hardships during peak months of the pandemic in 2021 and 2022, Demehin said.
For the upcoming year, 70.1% of hospitals will be charged penalties of less than 1% on their readmissions. That compares with 67.1% of hospitals in fiscal 2023.
Meanwhile, 7.5% of hospitals will be charged penalties of 1% or more in fiscal 2024, a percentage virtually unchanged from last year. Another 22.4%of hospitals will not be assessed penalties.
The average penalty for hospitals with the highest proportion of Medicare-Medicaid dual-eligible patients—peer group five—is 0.29%. For hospitals with the lowest number of dual-eligible patients—peer group one—the average penalty is 0.34%. During fiscal year 2023, groups five and one were penalized 0.23% and 0.37%, respectively, on their readmissions.
