Hospitals Rated Harder On Readmissions Than Mortality Rates
Penalties imposed on hospitals by Medicare are harsher for situations when patients have to be readmitted than when patients die, according to the results of a new study.
Researchers found that current Medicare incentives may be more focused on reducing hospital readmissions than reducing mortality rates. Unfortunately, lower readmission rates can also be linked to higher mortality rates in some situations.
Study looks at hundreds of hospitals
Researchers from the University of Michigan and the Ann Arbor Veterans Affairs Health System used 2014 hospital data, focusing specifically on readmissions as well as deaths due to heart failure, heart attack and pneumonia. The researchers discovered that of the nearly 2,000 hospitals with complete data available, the ones with higher readmission rates also tended to have the lowest mortality rates. However, those hospitals also received more penalties from Medicare for their readmission rates, with 17 percent of the hospitals receiving penalties for excessive readmissions.
On the flip side, around 16 percent of hospitals that were actually awarded for their low readmission rates also had patients that were likely to die within 30 days of their hospital stay. In fact, the current policy provides as many as 10 times more incentives for preventing readmissions more than preventing deaths. Under the current guidelines, hospitals can lose up to three percent of their Medicare payments for excessive readmissions. However, they only gain around 0.2 percent in rewards for low mortality rates.
“Current Medicare financial penalties do not meet the goals of aligning incentives and fairly reimbursing hospitals for patient-centered outcomes,” the authors of the study stated in response to their findings.
The study also notes that in the majority of situations, patients would rather avoid death than a hospital readmission. This fact illustrates the problem with the current policy, which does not appear to take the preferences of the patient into consideration. The current penalty and reward system seems to be more centered on cutting costs than in producing positive outcomes for patients.
Another study has similar findings
This is not the first study to show a problematic relationship between Medicare incentives and patient outcomes. Researchers at Johns Hopkins also found that hospitals with higher readmission rates also tended to have lower mortality rates among their patients. This study looked at 4,500 acute care facilities across the country to compile their data and results.
“It’s possible that global efforts to keep patients out of the hospital might, in some instances, place patients at risk by delaying necessary acute care,” Daniel J. Brotman, M.D., lead author in this study, told Science Direct.
There are steps that can be taken to reduce hospital readmissions without compromising patient safety. Improvements in coordination of care could have a positive impact, as well as providing patients with more resources and care after their hospital stay. However, the large number of factors that can affect a patient’s need for readmission make it difficult to reduce the number across the board, which is what Medicare’s policy seems to encourage.
There are also situations where readmission may be due to negligence or malpractice on the part of the physicians or hospital during a patient’s first admission. In these cases, the patient may have legal recourse to secure compensation for the additional medical expenses, lost wages and pain and suffering incurred.
If you or someone you love is harmed by negligence on the part of a health care provider, you do have legal rights. Contact The Sanders Firm medical malpractice lawyers at 1-800-FAIR-PLAY to get answers to all of your questions and receive a free evaluation of your case. Resources
- JAMA Cardiology, Association between Medicare Hospital Readmission Penalties and 30-Day Combined Excess Readmission and Penalty, https://jamanetwork.com/journals/jamacardiology/article-abstract/2572173
- JAMA Internal Medicine, Association between the Centers for Medicare and Medicaid Services Hospital Star Rating and Patient Outcomes, https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2513630
- Science Daily, Life and Death: Team Finds Hospital Readmissions Sometimes Save Lives, https://www.sciencedaily.com/releases/2016/09/160901125405.htm