Study Reports New Fines for Readmission can Hurt Patient Care
The federal government has revealed its list of regulations, which spans nearly 3,000 pages, regarding "2015 payment rates for various providers and services in the Medicare program, including physicians," The Hill reported. One of the new regulations includes a fine for hospitals with a high re-admission rate for patients with chronic obstructive pulmonary disease (COPD) and patients post hip/knee replacement surgery. According to the Centers for Medicare & Medicaid Services (CMS), too many patients are being re-hospitalized within a month of treatment.
The CMS calculated that one in five Medicare patients, in general, requires re-hospitalizations within one-month of discharge. Due to this "excessive" rate, the CMS plans on fining more than 2,600 hospitals with the hope that hospitals would improve care to avoid these fines. In a new study, researchers from the University of Michigan examined whether or not a fine would improve COPD patients' quality of care.
"We worry that this policy may cause more harm then good," stated study author Michael Sjoding, M.D., a pulmonary and critical care fellow in the U-M Medical School's Department of Internal Medicine, reported by Medical Xpress. "Medicare is trying to improve patient care and reduce waste, but the hospitals they are penalizing may be the ones who need the most help to do so."
The researches analyzed three years of information on 3,018 hospitals. Based on the hospitals readmission rates for COPD patients, the team concluded that the new fines would greatly impact teaching and safety-net hospitals. These types of hospitals tend to treat poor and/or medically complex COPD patients, who have a higher risk of readmissions due to other factors that the hospitals cannot control.
"If patients can't afford medications, or have unstable housing situation, they may end up being readmitted to the hospital," explained Sjoding. "No interventions to date have effectively and sustainably reduced COPD readmissions, so it's unclear what a hospital can do to prevent them."
The study was published in The American Journal of Respiratory and Critical Care Medicine