Medicare is set to penalize hospitals as much as $265,000 for each excess readmission after knee or hip replacement surgery. It is estimated that as many as 50 percent of all hospitals treating Medicare patients have above-average readmission numbers after a knee or hip replacement. As a result, these hospitals will be forced pay $265,000 for each returning patient above the established average.
The Centers for Medicare and Medicaid Services (CMS) is not solely focused on knee and hip replacements. Emphysema and chronic bronchitis (COPD) treatment is also under the microscope, with $32,000 penalties for above-average readmissions. US Hospitals are already paying up to $55,000 in penalties for heart attacks, heart failure and pneumonia related readmissions.
The goal of these hefty penalties is to force hospital administrators to focus on quality care. As far as CMS is concerned, if hospitals accepting Medicare patients cannot reduce readmissions through better care, they can reduce them by treating fewer seniors.
In a letter to Medicare on 6/14/13, the American College of Surgeons warned CMS about “the potential that these hospitals will decrease their care for such patients, thereby creating an access issue”. It is for health care providers to tell risky patients, “You are not a good candidate for treatment,” leaving patients to deteriorate.
For more reading on this subject, visit Kaiser Health News.