The federal government released a list Friday of regulations stipulating payment rates for 2015 for various services and providers part of the Medicare program. And in that list, a new policy targets hospitals with high re-admission rates for conditions like chronic obstructive pulmonary disease or COPD.
According to the new policy, over 2,600 hospitals will be fined in the coming year because too many Medicare patients are being re-admitted by these hospitals within just 30 days of being discharged. A study done by University of Michigan researchers also suggest that penalties for re-admissions involving COPD will have a bigger impact on those hospitals caring for the poor. According to the study, about one out of every five patients on Medicare are back in the hospital after no more than a month of being sent home after treatment, a rate that the Centers for Medicare & Medicaid Services finds unacceptable.
CMS has been reducing payments to hospitals with high re-admission rates since 2012 for patients suffering from heart attacks, heart failure, or pneumonia. For next year's payouts, COPD will be included in the calculations of possible penalties that will be levied on a hospital.
According Michael Sjoding, one of the researchers for the study, they are worried that the new policy imposed by the CMS will do more harm than good.
"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," he added.
Researchers assessed three years of data for the study taken from over 3,000 hospitals that cared for COPD patients. The researchers found out that based on past re-admission rates, safety-net and teaching hospitals are those that will be most affected by the CMS' new policy.
This is because these hospitals care the most for the poor or those with complex medical situations, individuals at high risk of re-admissions because of socio-economic and health factors. When they do get re-admitted, it is for reasons beyond the control of the hospital.
If patients cannot afford their medicines or don't have stable housing conditions, they are likelier to be re-admitted. To date, no interventions have effectively worked to sustainably reduce the number of COPD re-admissions so it is not clear what hospitals can do to keep re-admissions at bay.
Experts have suggested changes in the policy but so far it does not look like Medicare regulations will be changed to address the issue.
The study was published in The American Journal of Respiratory and Critical Care Medicine.
