How area hospitals fared in Obamacare penalties for avoidable readmissions
This includes the Affordable Care Act program to reduce avoidable hospital readmissions within 30 days of discharge, with penalties to facilities with readmission rates that are higher than expected for certain conditions.
The federal
Major medical facilities in the Buffalo Niagara region will all receive penalties below the national average for 2018.
The original goal, despite calls for repealing the health law, appears likely to remain no matter what happens: improve quality and control costs by preventing readmissions that result from medical errors, confusing discharge instructions, poor coordination among different health care providers or inadequate support at the patient's home.
The latest penalties represent a percentage of the hospitals' traditional Medicare program payments, up to a maximum of 3 percent, for excessive readmissions over a three-year period -- 2013 to 2016 -- for certain conditions: heart attacks, heart failure, pneumonia, chronic obstructive pulmonary disease, coronary bypass surgery, and hip or knee replacements.
The government did not release dollar figures for the penalties. But it estimated Medicare, the federal health program for people 65 and older, will save about
The government evaluated 3,241 hospitals, penalizing 80 percent of them,
Based on data from
Has the program worked?
A 2016 study in the
More recent research published in July in the
The federal program is not perfect but helps hospitals stay focused on issues that can reduce the cost of care, said
"A lot of this is about treatment in place, having programs in place that talk to each other at different levels of care, and making sure patients visit their primary care doctor shortly after they are discharged," he said. "We work on these things all the time."
Kane said the increase in patients insured under the Affordable Care Act may have helped control avoidable readmissions by linking them with primary care physicians and reducing their use of emergency rooms for basic care.
One of the criticisms about the readmission reduction effort is that it disproportionately penalizes hospitals that serve low-income and medically complex patients. To address that,
Another criticism is that hospitals get penalized regardless of the reason for the readmission.
"If a heart failure patient goes home, breaks a leg and ends up back in the hospital, that's not something we could have avoided," Kane said. "We need an adjustment to link the readmission to the issues that cause them."
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