Editor’s Note: Recent news reports that over half of the nation’s hospitals are hit with penalty from CMS. See story below. BHM helps healthcare organizations become more efficient and meet important metrics, like the CMS Readmission goal. Click here to schedule your free consultation.

Hospital Readmissions penalties run high as the government plans to penalize more than half of the nation’s hospitals. Over the next year Medicare plans to withhold more than a half a billion dollars in payments, reports Kaiser Health news. In 2015 alone hospital readmissions penalties hit a total of $420 million¹.

The penalties, which will roll-out in October, are based on the re-hospitalization rate for patient with six common conditions. Kaiser Health News reports “since the Hospital Readmissions Reduction Program began in October 2012, national readmission rates have dropped as many hospitals pay more attention to how patients fare after their release.”

The following facts come from the same KHN report:

Changes in how readmissions are measured is expected to result in penalties that total $528 million. Kaiser News reports, “Each hospital, the government calculated how many readmissions it expected, given national rates and the health of each hospital’s patients. Hospitals with more unplanned readmissions than expected will receive a reduction in each Medicare case reimbursement for the upcoming fiscal year that runs from Oct. 1 through September 2017.”

  • 49 hospitals received the maximum fine. The average penalty was .73% of each Medicare payment.
  • KHN reports 1,621 hospitals have been penalized in each of the five years of the program

5 Factors to Help Decrease Readmissions

Reducing hospital readmissions requires the entire organization to be aware and on board. Your whole organization must be aware of the proper protocols and how to follow them.

  • Reduce systemic stumbling points
  • Use better discharge planning
  • Target high-risk populations
  • Include Population Health and clinical data when analyzing readmissions data
  • Embrace payment reforms