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A hospital readmission is an episode when a patient who had been discharged from a hospital is admitted again within a specified time interval. Readmission rates have increasingly been used as an outcome measure in health services research and as a quality benchmark for health systems.
Pay for performance systems link compensation to measures of work quality or goals. Current methods of healthcare payment may actually reward less-safe care, since some insurance companies will not pay for new practices to reduce errors, while physicians and hospitals can bill for additional services that are needed when patients are injured by mistakes. [1]
The maximum penalty will increase after this year, to 2 percent of regular payments starting in October 2013 and then to 3 percent the following year. As an example, if a hospital received the maximum penalty of 1 percent and it submitted a claim for $20,000 for a stay, Medicare would reimburse it $19,800.
The highest penalties on hospitals are charged after knee or hip replacements, $265,000 per excess readmission. [44] The goals are to encourage better post-hospital care and more referrals to hospice and end-of-life care in lieu of treatment, [45] [46] while the effect is also to reduce coverage in hospitals that treat poor and frail patients.
Healthcare reform in the United States has had a long history.Reforms have often been proposed but have rarely been accomplished. In 2010, landmark reform was passed through two federal statutes: the Patient Protection and Affordable Care Act (PPACA), signed March 23, 2010, [1] [2] and the Health Care and Education Reconciliation Act of 2010 (), which amended the PPACA and became law on March ...
An evaluation published in late 2007 showed that 117 patients who received "ProvenCare" had a significantly shorter total length of stay (resulting in 5% lower hospital charges), a greater likelihood of being discharged to home, and a lower readmission rate compared with 137 patients who received conventional care in 2005. [22]
An Idaho inmate who slipped custody from a hospital in March after a violent attack on corrections officers has pleaded guilty to escape, while still facing the possibility of two felony ...
A set of 10 hospital quality measures which, if reported to CMS, will increase the payments that hospitals receive for each discharge. By the third year of the demonstration, those hospitals that do not meet a threshold on quality will be subject to reductions in payment.