Medicare to Punish Hospitals for Readmissions: Are Patients at Risk?

Government health spending has reached an all time high.  In order to lower the costs of Medicare's nearly $556 billion price tag this year, the organization has begun to fine hospitals for too many readmissions. Approximately 2,217 hospitals will incur heavy fines this year that could number into the millions.

The Congressional Budget Office estimates hospital inpatient costs make up 1/4 of this year's spending with another 4% annual increase in costs. To lower spending, Medicare is providing financial incentive for hospitals to reduce readmissions.  However, what happens when these hospitals are fined repeatedly? Will that lower the ability to care for patients?

Are Patients at Risk?

Currently, approximately 1 in 5 Medicare patients is readmitted within the month.  This costs an estimated $17 billion a year.  Patients are at risk because Medicare pays a fixed amount for a hospital stay, incentivizing hospitals to apply quick fixes and get the patients back out on the street so the hospital can keep more of that revenue.  When patients return, the hospital is paid again.  These fines are intended to incentivize hospitals to treat a patient's ailments the first time, so they don't need to keep coming back.

Medicare is set to roll out a system of financial punishments to dissuade these practices.  But to date, these fines are levied against hospitals that appear to be inadequately treating heart attack, heart failure and pneumonia patients.  Perhaps under this new system patients can receive more holistic care to prevent the need for successive visits.

To date, suspicions are arising that some hospitals are merely cheating the system by sending patients home within 24 hours so the admission doesn't count against them.  In such a manuever, the hospital could keep the money by pushing a patient out prematurely. Will we soon see patients dropped off in cabs on the curb?

If You are Harmed

If you have been injured because the hospital is trying to cheat the system, or because their fines have led to a significant and risky reduction in care, you may be entitled to compensation.  You should discuss your concerns with a skilled personal injury lawyer to help protect your rights.