Healthcare News & Insights

New bill would help hospitals with readmissions

Reducing hospital readmissions is at the forefront of every healthcare executive’s mind, especially since hospitals face growing penalties from Medicare for high readmission rates. However, a new bill pending in Congress may make compliance a bit easier on facilities. 

GettyImages-101410325The Helping Hospitals Improve Patient Care Act was introduced by Reps. Jim McDermott (D-Wash) and Pat Tiberi (R-Ohio). It was designed to keep hospitals from being penalized based on the patient mix they serve – specifically, to take patients’ socioeconomic status into account when calculating readmission rates.

Bill addresses several issues

Many hospitals object to the current criteria of the federal readmissions reduction program, saying their facilities are unfairly penalized for poor outcomes when patients have extenuating circumstances outside of their hospital care that hospitals can’t control.

According to a summary of the bill, the pending legislation would better account for these factors by comparing the performance of hospitals that serve similar proportions of patients who receive both Medicare and Medicaid (or dual-eligibles).

In addition, Medicare is reviewing other hospital data under the Improving Medicare Post Acute Care Transformation Act of 2014 (IMPACT), and the results from that analysis would also be taken into account when determining readmissions penalties for hospitals.

Besides these adjustments to readmissions rates, the act also includes provisions that address payment rates for off-campus hospital outpatient departments and off-campus cancer centers. Other portions address:

  • an exception to current regulations for increasing the number of beds in long-term care hospitals,
  • an extension to the rural community hospital demonstration program, and
  • modification of the treatment of ambulatory surgery center patient encounters.

Ultimately, per a news release, the bill is designed to support hospitals’ efforts in creating more outpatient facilities and treating disadvantaged patients, as well as those battling cancer.

Several hospital lobbying groups have come out in support of the bill so far. In a statement on its website, the American Hospital Association (AHA) praises the representatives for coming up with legislation that addresses issues impacting both hospital outpatient facilities and readmission rates.

The AHA said it’ll continue to review the bill and take a proactive approach to making suggestions to further improve patient care.

What this means for hospitals

If this bill passes, it’ll make life easier for hospitals that serve patients with multiple socioeconomic issues.

But just because there may be some leeway coming, it doesn’t mean that hospitals should rest easy. It’s still critical to use all the resources available to provide the best care possible to patients from all socioeconomic backgrounds – especially since each facility’s performance will be stacked up against that of its peers to determine if penalties are warranted.

We’ll keep you posted on any developments with the bill.

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