The Washington Post /Kaiser Health News reported, "Medicare is preparing to penalize hospitals with frequent potentially avoidable readmissions," with the aim of prodding them "to make sure patients get the care they need after discharge. But this new policy is likely to disproportionately affect hospitals that treat the most low-income patients, according to a Kaiser Health News analysis of data from the Centers for Medicare & Medicaid Services." In fact, "hospitals that served the most poor Medicare patients were nearly three times as likely as others to have substantially high readmission rates for heart failure, the analysis found." Because these hospitals already run on tight budgets, many are afraid the penalties will make it even more difficult for them to care for poor patients properly.
Readmission rates at 3,119 hospitals scrutinized. In a related story, the Washington Post /Kaiser Health News detailed the methodology behind the Kaiser Health News (KHN) analysis of 3,119 facilities. For the analysis, "KHN looked at congestive heart failure, which is the most common cause of rehospitalization for Medicare patients. Readmission rates came from Medicare's Hospital Compare Web site, which publishes risk-adjusted rates for heart failure and two other conditions (pneumonia and heart attacks)." Specifically, "the data cover patients who were readmitted within 30 days of discharge between July 2007 and June 2010." Finally, "to gauge the socioeconomic status of each hospital's patient population, KHN relied on an index that the Centers for Medicare & Medicaid Services (CMS) uses to decide whether a hospital deserves 'Disproportionate Share Hospital' (DSH) payments because it treats an excess of poor patients."
Post-discharge clinics are new strategy to prevent readmissions. In "Insuring Your Health," Kaiser Health News reported, "According to a study released this month by the Center for Studying Health System Change, a Washington-based research group, a third of adult patients discharged from a hospital don't see a physician within 30 days -- and experts say this is a key reason so many of them are readmitted." Now, "some hospitals are trying a new strategy to interrupt this predictable and pricey pattern: post-discharge clinics. These hospitals are identifying patients who are more likely to have trouble after discharge, either because of their medical conditions or because they lack health insurance or a primary-care provider, and funneling them to the clinic where they receive one-on-one assistance." Still, some experts question if such clinics are really the best solution. What's more, experience has shown that up to half of the patients fail to keep post-discharge appointments.
From the news release of the American Association for Justice.