While pressing for relief from a penalty tied to readmission rates, hospital executives showed how the Medicare policy is spurring a deeper look at how some of the poorest Americans live.
The American Hospital Association briefed congressional staff Thursday about its bid to change the penalty policy, which it is seeking to attach to a measure that designed to prevent a cut in Medicare payments to doctors.
About 2,600 hospitals faced fines related to relatively high readmission rates for certain conditions in fiscal 2015, with penalties totaling about $428 million, according to the AHA.
Hospital officials contend that Medicare should factor in the socioeconomic status of patients served when assessing the readmission fee for hospitals. The penalty, created by the 2010 health law, is leading hospitals to more carefully consider what happens to patients after they are discharged for select common conditions, such as heart failure and heart attacks.
“They honestly may not have somewhere to go that night when you discharge them,” said Rachel George of Illinois’ Presence Health. “They certainly may have to make choices about whether they pick up their medication or they are going to eat, or if they are going to pick up their medications or if they are going to stand in line for a shelter.”
Her hospital network is trying to help patients avoid readmissions with steps such as providing 30 days worth of medication, she said.
In the end, though, there is only so much that hospitals can control, she said.
“To penalize hospitals because we cannot solve the socioeconomic issues in the communities that we face, that’s a challenge,” she said.
In addition to trying to attach a bill on the readmission penalty to the doc fix measure, the AHA is backing bills (HR 1343, S 688) that have been introduced in both chambers addressing this issue.