Majority Of Hospitals Dinged By CMS
The Centers for Medicare & Medicaid Services plans to penalize a record number of hospitals for readmitting certain patients within 30 days of discharge. California hospitals are no exception, although they are faring better in this round than the average hospital nationwide.
A total of 223 hospitals, or 64% in California, will be penalized under the Hospital Readmissions Reduction Program, according to CMS data. That's significantly lower than the nationwide average of 75% of hospitals being penalized.
The average penalty for California hospitals will total 0.41% of Medicare revenue paid for the readmitted patients. That is also significantly lower than the average nationwide penalty of 0.63% of payments, although it is higher than last year's nationwide average penalty of 0.38%.
The rise in penalties is less a reflection in how hospitals are faring overall than the fact CMS added two categories of patients – those who underwent knee and hip replacement surgeries -- to the list of those whose readmission will lead to a financial penalty. Over the past two years, CMS also dinged hospitals for readmitting patients who were treated for heart failure, heart attack and pneumonia.
Penalties are assessed based on the number of patients readmitted, and range from one hundredth of 1 percent to a maximum of 3%. Only one hospital in California, Sutter Surgical Hospital North Valley in Yuba City, received the maximum penalty. Just two other hospitals -- Chinese Hospital in San Francisco and Enloe Medical Center in Chico -- received penalties that exceeded 2%.
Only four hospitals operated by Kaiser Permanente received penalties of any kind, and none was higher than 0.14%. Twenty-four others received no penalty at all.
A total of 39 hospitals in the U.S. are receiving the maximum penalty, and many of them are surgical specialty or smaller community facilities.
Altogether, 2,610 hospitals nationwide are being fined by CMS. About 18% of patients – about 2 million in total – were readmitted last year, according to data from the agency. About 1,400 hospitals are exempt from penalties because they provide specialty care such as cancer or inpatient psychiatric services.
