Medicare Penalizes 25 Hospitals For Readmissions, But Fines Lower Due To COVID

Twenty-five Connecticut hospitals will lose some of their Medicare reimbursement payments starting this month as penalties for having too many readmitted patients. Still, in most cases, the fines are much lower than in previous years, new data from the Centers for Medicare and Medicaid Services (CMS) show. In this year’s evaluation, CMS considered the COVID-19 pandemic and its impact on hospitals, excluding data for the first half of 2020 and Medicare patients readmitted with pneumonia, according to a report in Kaiser Health News. Nationally, Medicare is penalizing 2,273 hospitals, the fewest since 2014, with an average payment reduction of 0.43%, Kaiser reported. In Connecticut, 69% of all hospitals in the program face fines, but most are under 1%.

Medicare Penalizes 26 CT Hospitals For High Readmission Rates

Twenty-six Connecticut hospitals will lose some of their Medicare reimbursement payments over the next year as penalties for having too many readmitted patients, new data from the Centers for Medicare and Medicaid Services (CMS) show. Nationally, Medicare is reducing payments to 2,499 hospitals, about 47% of all facilities, with the average penalty being 0.64%, according to a report by Kaiser Health News (KHN). This year’s penalties were based on tracking patients from July 1, 2017 through Dec. 1, 2019, so the influx of patient care during the pandemic is not included, CMS said. In Connecticut, 72 % of all hospitals in the program will face a loss in CMS payments, beginning October 2021 through September 2022.

15 Hospitals Penalized For High Infection Rates, Injuries

About half of Connecticut hospitals—15 out of 31—will lose part of their Medicare payments in 2018 as a penalty for having relatively high rates of patients who acquired preventable injuries and infections while hospitalized. The hospitals are among 751 nationwide that will lose 1 percent of their Medicare reimbursements in this fiscal year. The penalties are part of the Centers for Medicare and Medicaid Services’ (CMS) Hospital-Acquired Condition Reduction Program, which is part of the Affordable Care Act. The program penalizes hospitals with the highest rates of patients who got infections from hysterectomies, colon surgeries, urinary tract catheters and central line tubes. It also tallies those who suffered from blood clots, bed sores or falls while hospitalized.