Heather Punke: 10 Things to Know About the Hospital Readmissions Reduction Program

1. The Hospital Readmissions Reduction Program was created under the Affordable Care Act.
2. This year's penalties are based on readmissions from July 2011 to June 2014 for Medicare patients for heart attack, heart failure, pneumonia, COPD, or hip/knee replacements.
3. There are 18 fewer hospitals penalized this year than last year.
4. The penalties will take effect from Oct. 1 through Sept. 30, 2016, and are projected to cost the hospitals a combined $420 million.
5. To determine the level of penalty levied against each hospital, CMS uses a formula to determine what the appropriate number of unplanned 30-day readmissions would be for each hospital.
6. The maximum penalty this year is a 3 percent reduction in Medicare payments, which 38 hospitals will receive this year compared to 39 hospitals last year.
7. Four hospitals have received the maximum penalty each year under the program: Two in Kentucky, one in Louisiana and another in Tennessee
8. A total of 506 hospitals will have Medicare reimbursements docked by 1 percent or more.
9. Not all hospitals are subject to the program.
10. The Readmissions Reduction Program is not without its fair share of controversy.

Source: Becker's Infection Control and Clinical Quality, August 4, 2015
Source URL: http://www.beckershospitalreview.com/quality/2-5k-hospitals-...

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