Readmission Penalties Will Rise For State\'s Hospitals
A total of 225 hospitals in California will be penalized by the Medicare program in the next fiscal year for having too many inpatients being readmitted with 30 days of discharge for certain medical conditions.
Altogether, the average Medicare payment reduction for hospitals in California will be 0.55%, according to an analysis by Kaiser Health News. That's up from an average 0.39% penalty in the previous year. A total of 49 hospitals received higher-than-average penalties, which can range up to a maximum cut of 3% in Medicare payments. Records show that Oroville Hospital in rural Butte County is the only facility in the state to receive a 3% cut this coming year. It received a 0.98% cut for the current fiscal year.
The payment reductions are part of the Hospital Readmissions Reduction Program mandated by the Affordable Care Act and initiated in 2012. Hospitals are being scrutinized for readmissions involving the following conditions and procedures: Heart attacks, heart failure, pneumonia, chronic lung disease, hip and knee replacements and coronary artery bypass graft surgery. The current penalties are based on admissions and discharge data between July 2012 and June 2015. The cuts apply to Medicare payments in total, including all care provided by hospitals. They cover the 2017 fiscal year and begin Oct. 1 and run through Sept. 30, 2017.
For the upcoming year, the Centers for Medicare & Medicaid Services projects that it will penalize nearly 2,600 hospitals statewide and withhold $528 million in payments. That's up more than $100 million compared to the previous year.