Readmission Penalties Article Critique

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Hospitals with more elderly, poor patients likely to face readmission penalties" by Katie Sullivan (January 8, 2014)

Are some hospitals discharging patients before they are ready, causing them to be subsequently readmitted? This would seem to be the issue involved in the recent decision by the federal government to assess penalties if hospitals treat so-called "dual-eligible seniors," or those eligible for medical care under both Medicare and Medicaid, because these patients are at higher risk of readmission within 30 days of discharge. According to an article by Sullivan (2014), the reality of the situation is that the majority of the hospitals that will be adversely affecting by this decision are those whose treatment area contains inordinately higher percentages of senior citizens who require a greater share of healthcare resources compared to their younger counterparts. Moreover, the quality of care being provided in these hospitals is not generally at issue. In this regard, Sullivan reports that, "Researchers found hospital quality wasn't generally to blame, but that the hospitals were in regions with fewer or lower quality primary care resources, increasing the likelihood of a patient getting readmitted within 30 days" (2014, para. 2).

Despite this lack of actual accountability, the decision to charge these hospitals penalties can have some enormous financial consequences.

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According to Sullivan, "Those hospitals are more likely to have their [Centers for Medicare & Medicaid Services] payments cut -- up to 3% by 2015 -- under the Hospital Readmission Reduction Program, which is intended to reduce the number of pneumonia, heart attack or heart failure readmissions" (2014, para. 3). More troubling still, the majority of the hospitals that are most adversely affected by this decision are those that are already financially strapped as a result of providing medical care for indigent health care consumers who are unable to pay for their services.

Some of the potential alternatives that are purportedly available to avoid this double-whammy penalty are nearly as laughable as the decision to implement such as policy itself. For instance, Sullivan suggests that it would be possible to avoid the penalties from the Centers for Medicare & Medicaid Services if the federal government changes existing measures of quality to allow hospitals to report their readmissions differently. Likewise, it might be possible to avoid the current double-whammy penalty by changing the manner in which the Centers for Medicare & Medicaid Services authorizes payment for initial and….....

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https://www.aceyourpaper.com/essays/readmission-penalties-181259
   

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