Fifty-five Indiana hospitals are being docked by the federal government for a total of more than $8 million because too many Medicare patients are returning for treatment within a month of being discharged.
The number is down from 62 hospitals last year and 66 last year, but will still cost many hospitals money while still coping with the strain of the pandemic, which has overstretched resources and reduced their revenues and profits.
The federal government says readmissions are often unnecessary and cost taxpayers tens of billions of dollars annually for treatments that should have been discovered the first time or were not adequately followed up.
For the 11th year in a row, she’s using the pressure of lower reimbursements to get hospitals to improve their numbers.
The Centers for Medicare & Medicaid Services announced Monday that they would fine 2,273 hospitals across the country. According to an analysis by Kaiser Health News, this is the fewest since the fiscal year that ended in September 2014.
The Indiana Hospital Association estimates the total amount of penalties assessed at $8.14 million, down 1.3% from a year ago.
“Indiana hospitals are committed to quality and have worked diligently to improve discharge planning processes, care coordination, patient education and the social determinants of health in their communities,” the hospital association IBJ said in an email. “We are proud to report that 74% of Indiana hospitals have stayed the same or improved over the past year. Additionally, Indiana outperformed neighboring states of Michigan, Illinois and Kentucky in reducing readmission rates.”
For hospitals that face a fine, the penalty ranges from $0 to $970,600, with the average being $150,756, the association said.
“Hospital readmission reporting is just one of many quality actions taken by the federal government, and Indiana performs exceptionally well when looking at the patient safety continuum,” the association said. “In fact, Indiana ranks 10th in the nation when looking at a compilation of patient safety indicators and compares best to Illinois, Kentucky, Michigan and Ohio.”
The numbers do not include Indiana hospitals that Medicare exempted from the program either because they had too few cases to evaluate; were veterans’ hospitals, children’s hospitals, psychiatric hospitals; or were critical access hospitals, which are the only hospitals accessible for some patients. In Indiana, 65 hospitals were exempted for this reason.
The maximum penalty is a 3% reduction in payments in Medicare payments. The highest penalty against an Indiana hospital was a 2.71% cut in payments for Hobart’s St. Mary Medical Center, which is owned by the Munster-based Community Healthcare System.
Many hospitals say they are making efforts to monitor patients and help them recover to avoid avoidable readmissions. They send patients home with thick, detailed discharge instructions and medication for a month. Hospitals send nurses and aides to patients’ homes to see how they are doing. In some cases, patients receive vouchers for taxis or van shuttles to get to their GPs for follow-up visits.
Penalties are based on the rate of readmissions of Medicare patients originally treated for heart failure, heart attack, pneumonia, chronic lung disease, hip and knee replacements, or coronary artery bypass graft surgery. Scheduled resumes are not counted.
Fifteen Indiana hospitals received no penalties this year, including Eskenazi Health in Indianapolis, Hendricks Regional Health in Danville, Ascension St. Vincent hospitals in Carmel and Fishers, Ortho Indy Hospital in Indianapolis, Franciscan Health hospitals in Crawfordsville, Lafayette and Mooresville, as well Indiana University Health in Bloomington.
In central Indiana, 13 hospitals face penalties:
Hancock Regional Hospital (Greenfield): 1.55%
Riverview Health (Noblesville): 1.31%
Community Health East (Indianapolis): 1.13%
Indiana University Health North (Carmel): 0.75%
Community Health South (Indianapolis): 0.6%
Indiana University Health West (Avon): 0.57%
Franciscan Health (Indianapolis): 0.4%
Large Hospital (Shelbyville): 0.39%
Indiana University Health Methodist/University (Indianapolis): 0.37%
Witham Health (Lebanon) 0.36%
Ascension St. Vincent (Indianapolis): 0.12%
Community Health North (Indianapolis): 0.1%
Johnson Memorial Hospital (Franklin): 0.03%