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Readmission rate could mislead as quality indicator, hospitals say
NEWS IN BRIEF — Posted Oct. 3, 2011
Using a hospital's readmission rate to judge its quality and exact financial penalties could be misleading to patients and unfair, according to a September American Hospital Assn. report (link).
Starting in October 2012, hospitals could see their Medicare pay cut by up to 1% if they have higher than expected 30-day readmission rates for patients with heart attack, heart failure or pneumonia. The cut could be as high as 3% starting in 2014.
But the AHA's report said the standards the government plans to use for risk adjustment leave out factors known to be associated with higher rates of readmission, such as race, ethnicity, limited English proficiency and Medicaid coverage. And not all readmissions are created equal, the report said. Many readmissions are planned, and others are for conditions unrelated to the initial hospitalization and would be difficult for physicians and hospitals to prevent.
Note: This item originally appeared at http://www.ama-assn.org/amednews/2011/10/03/prbf1003.htm.
