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Senators Propose Bill to Ease Readmission Penalties on Some Hospitals

Care centers penalized for treating low-income patients

According to a report from Kaiser Health News, a bipartisan group of senators has introduced legislation to make Medicare take the financial status of hospital patients into account when deciding whether to punish a hospital for too many readmissions.

The bill attempts to address one of the main complaints about the readmissions program: that hospitals serving large numbers of low-income patients are more likely be penalized.

Over the past 2 years, the federal government has reduced payments to two-thirds of the nation’s hospitals because they have high numbers of patients becoming ill and returning after being discharged, the report says. This fall, the program will put as much as 3% of a hospital’s Medicare payments at risk, and it will expand the number of conditions it bases the assessment on — currently heart attack, heart failure, or pneumonia — to include chronic obstructive pulmonary disease and total hip and knee replacement.

Medicare does adjust for different levels of sickness of patients among hospitals, but it has said that the Patient Protection and Affordable Care Act, which created the program, does not give regulators the leeway to take socio-economic status into account.

An advisory committee to Congress last year recommended that lawmakers change the program. The idea of taking patients’ socio-economic status into account has also been endorsed by a panel created by the National Quality Forum — a nonprofit group that reviews quality measures for the government.

The bill is sponsored by Democratic Senators Joe Manchin of West Virginia and Bill Nelson of Florida. The Republican sponsors are Sens. Roger Wicker of Mississippi and Mark Kirk of Illinois. The bill does not specify how to revise the penalty program, leaving that up to Medicare.

The American Hospital Association endorsed the bill and announced that it would push for its passage.

Source: Kaiser Health News; June 19, 2014.

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