More than 2,000 hospitals — including some nationally recognized ones — will be penalized by the government starting in October because many of their patients are readmitted soon after discharge, new records show.
Together, these hospitals will forfeit about $280 million in Medicare funds over the next year as the government begins a wide-ranging push to start paying health care providers based on the quality of care they provide.
In Maine, 10 hospitals will be penalized. They are: Penobscot Bay Medical Center in Rockport, Mercy Hospital in Portland, Franklin Memorial Hospital in Farmington, Goodall Hospital in Sanford, Maine Coast Memorial Hospital in Ellsworth, MaineGeneral Medical Center in Augusta, St. Mary’s Regional Medical Center in Lewiston, York Hospital in York, and Brunswick’s Mid Coast Hospital and Parkview Adventist Medical Center.
With nearly one in five Medicare patients returning to the hospital within a month of discharge, the government considers readmissions a prime symptom of an overly expensive and uncoordinated health system. Hospitals have had little financial incentive to ensure patients get the care they need once they leave, and in fact they benefit financially when patients don’t recover and return for more treatment.
Nearly 2 million Medicare beneficiaries are readmitted within 30 days of release each year, costing Medicare $17.5 billion in additional hospital bills. The national average readmission rate has remained steady at slightly above 19 percent for several years, even as many hospitals have worked harder to lower theirs.
The penalties, authorized by the 2010 health care law, are part of a multipronged effort by Medicare to use its financial muscle to force improvements in hospital quality. In a few months, hospitals also will be penalized or rewarded based on how well they adhere to basic standards of care and how patients rated their experiences. Overall, Medicare has decided to penalize around two-thirds of the hospitals whose readmission rates it evaluated, the records show.
The penalties will fall heaviest on hospitals in New Jersey, New York, the District of Columbia, Arkansas, Kentucky, Mississippi, Illinois and Massachusetts, a Kaiser Health News analysis of the records shows. Hospitals that treat the most low-income patients will be hit particularly hard.
A total of 278 hospitals nationally will lose the maximum amount allowed under the health care law: 1 percent of their base Medicare reimbursements. Several of those are top-ranked institutions, including Hackensack University Medical Center in New Jersey, North Shore University Hospital in Manhasset, N.Y. and Beth Israel Deaconess Medical Center in Boston, a teaching hospital of Harvard Medical School.
“A lot of places have put in a lot of work and not seen improvement,” said Dr. Kenneth Sands, senior vice president for quality at Beth Israel. “It is not completely understood what goes into an institution having a high readmission rate and what goes into improving” it.
Sands noted that Beth Israel, like several other hospitals with high readmission rates, also has unusually low mortality rates for its patients, which he says may reflect that the hospital does a good job at swiftly getting ailing patients back and preventing deaths.
Penalties Will Increase Next Year
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. This year, the $280 million in penalties comprise about 0.3 percent of the total amount hospitals are paid by Medicare.
According to Medicare records, 1,933 hospitals will receive penalties less than 1 percent; the total number of hospitals receiving penalties is 2,211. Massachusetts General Hospital in Boston, which U.S. News last month ranked as the best hospital in the country, will lose 0.5 percent of its Medicare payments because of its readmission rates, the records show. The smallest penalties are one hundredth of a percent, which 50 hospitals will receive.
Maine’s penalties averaged 0.09 percent.
Dr. Eric Coleman, a national expert on readmissions at the University of Colorado School of Medicine, said the looming penalties have captured the attention of many hospital executives. “I’m not sure penalties alone are going to move the needle, but they have raised awareness and moved many hospitals to action,” Coleman said.
The penalties have been intensely debated. Studies have found that African-Americans are more likely to be readmitted than other patients, leading some experts to be concerned that hospitals that treat many blacks will end up being unfairly punished.
Hospitals have been complaining that Medicare is applying the rule more stringently than Congress intended by holding them accountable for returning patients no matter the reason they come back.
Hospitals That Serve Poor Are Hit Harder Than Others
Some safety-net hospitals that treat large numbers of low-income patients tend to have higher readmission rates, which the hospitals attribute to the lack of access to doctors and medication these patients often experience after discharge. The analysis of the penalties shows that 76 percent of the hospitals that have a lot of low-income patients will lose Medicare funds in the fiscal year starting in October. Only 55 percent of the hospitals treating few poor patients are going to be penalized, the analysis shows.
“It’s our mission, it’s good, it’s what we want to do, but to be penalized because we care for those folks doesn’t seem right,” said Dr. John Lynch, chief medical officer at Barnes-Jewish Hospital in St. Louis, which is receiving the maximum penalty.
“We have worked on this for over four years,” Lynch said, but those efforts have not substantially reduced the hospital’s readmissions. He said Barnes-Jewish has tried sending nurses to patients’ homes within a week of discharge to check up on them, and also scheduled appointments with a doctor at a clinic, but half the patients never showed. This spring, the hospital established a team of nurses, social workers and a pharmacist to monitor patients for 60 days after discharge.
“Some of the hospitals that are going to pay penalties are not going to be able to afford these types of interventions,” said Lynch, who estimated the penalty would cost Barnes-Jewish $1 million.
Atul Grover, chief public policy officer for the Association of American Medical Colleges, called Medicare’s new penalties “a total disregard for underserved patients and the hospitals that care for them.” Blair Childs, an executive at the Premier healthcare alliance of hospitals, said: “It’s really ironic that you penalize the hospitals that need the funds to manage a particularly difficult population.”
Medicare disagreed, writing that “many safety-net providers and teaching hospitals do as well or better on the measures than hospitals without substantial numbers of patients of low socioeconomic status.” Safety-net hospitals that are not being penalized include the University of Mississippi Medical Center in Jackson and Denver Health Medical Center in Colorado, the records show.
Bill Kramer, an executive with the Pacific Business Group on Health, a California-based coalition of employers, said the penalties provide “an appropriate financial incentive for hospitals to do the right thing in terms of preventing avoidable readmissions.”
The government’s penalties are based on the frequency that Medicare heart failure, heart attack and pneumonia patients were readmitted within 30 days between July 2008 and June 2011. Medicare took into account the sickness of the patients when calculating whether the rates were higher than those of the average hospital, but not their racial or socio-economic background.
The penalty will be deducted from reimbursements each time a hospital submits a claim starting Oct. 1. 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 Centers for Medicare & Medicaid Services has been trying to help hospitals and community organizations by giving grants to help them coordinate patients’ care after they’re discharged. Leaders at many hospitals say they are devoting increased attention to readmissions in concert with other changes created by the health law.
Sally Boemer, senior vice president of finance at Mass General, said she expected readmissions will drop as the hospital develops new methods of arranging and paying for care that emphasize prevention. Readmissions “is a big focus of ours right now,” she said.
Gundersen Lutheran Health System in La Crosse, Wis., and Intermountain Medical Center in Murray, Utah, were among 1,156 hospitals where Medicare determined the readmission rates were acceptable. Those hospitals will not lose any money. On average, the readmissions penalties were lightest on hospitals in Utah, South Dakota, Vermont, Wyoming and New Mexico, the analysis shows. Idaho was the only state where Medicare did not penalize any hospital.
Even some hospitals that won’t be penalized are struggling to get a handle on readmissions. Michael Baumann, chief quality officer at the University of Mississippi Medical Center, said in-house doctors had made headway against heart failure readmissions by calling patients at home shortly after discharge. “It’s a fairly simple approach, but it’s very labor intensive,” he said.
The problems afflicting many of the center’s patients—including obesity and poverty that makes it hard to afford medications—make it more challenging. “It’s a tough group to prevent readmissions with,” he said.
jrau@kff.org
The Bangor Daily News contributed additional Kaiser Health News data to this report.
Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communications organization not affiliated with Kaiser Permanente.
welcome to the beginning of obama care.
This was in the works long before Obama.
but, when was it passed? thank you Obama, and Obama Healthcare will make all worse. Here we go, just the start.
wrong again.
Whats wrong with making hospitals accountable for the care of their patience. The monies that they are fined with will go to the hospitals that do care in a reward system. Tell you what, you go to the hospital that friggs you up and I will go to the ones that are rewarded for the good care of their patients. See who comes out smelling like a rose.
Where did you get the idea that readmissions were the fault of the hospital?
Well let me see. The article was on the readmission’s to the hospitals and that they are being made accountable for the inner workings of their establishment. For what ever reason, the Dr’s., Nurses, the emergency rooms, the lab techs and so on that are responsible for patients coming back to hospital with in 30 days. The hospital is the caretaker and will get the fine or the reward. They in turn will do with it what they wish. I did not have to read this article to know that a hospital is responsible for what ever goes on in side its walls. I think this is a great idea.
When
a patient is readmitted, it is not necessarily related to the original
illness/reason for previous hospital admission. How is it the fault of
the hospital if someone who was in for heart failure comes back with
appendicitis? Some of the time there is no relationship between the
hospitalizations. If those fines continue, medicare patients will become
a bad risk and will not be hospitalized for some illnesses.
Give me a break, fear tactics are old news now. The hospitals will be on an individual basis for fines and rewards. Each circumstance will be reviewed and dealt with. Medicare patient will be OK and maybe even better then their first visit. Once a hospital realizes that they are not getting away with stuff anymore. It won’t be business as usual that’s for sure.When your heart patient comes in for appendicitis it wont be a readmittance. Its a completely different problem and will be treated as so.
When a patient is readmitted, it is not necessarily related to the original illness/reason for previous hospital admission. How is it the fault of the hospital if someone who was in for heart failure comes back with appendicitis? Some of the time there is no relationship between the hospitalizations. If those fines continue, medicare patients will become a bad risk and will not be hospitalized for some illnesses.
it is based on readmission for the same thing, not readmission for a completely different thing.
And you are assuming compliance with the treatment plan by the patients? Not a good assumption. Sometimes it isn’t the patient’s fault, such as overly expensive meds or needing outpatient follow up with no means to get there, but sometimes the patient’s simply don’t do what is prescribed and end up back for the same thing. This is certainly not always the case, and hospitals certainly do screw up, but there are too many variables out of the control of the hospital for this to be fair.
and you are assuming a perfect world? No patients aren’t going to always comply, so yes they will end up back in the hospital. But, what they are asking the hospitals to do is make extra efforts to not only care for the patient at inpatient, but to do that follow up care. “care management” is what they call it, to make sure those patients get their prescriptions, that they take them, that there are no barriers to keep them getting them. Many of the hospitals that are in compliance with these new guidelines have care managers on staff and are working with PCP offices that also have care managers on staff that work with their patients to make sure they have every resource they need to keep them out of the hospital. There are always going to be those that will go to the ER repeatedly, who will seek meds, who will seek attention by going to the ER, they are the “frequent flyers” but those patients will not get admitted unless they are truly so sick they need to be inpatient because the hospital under this new system doesn’t get paid the same way. This new system is teaching the hospital to be proactive in managing their patients and helping the patient to learn to manage their care rather then send them home and say “there you go, take care”.
There is nothing making hospitals acctountable. The fact is a lot of times people can feel better and get released and are back in the hospital in a few days or a week. That is not necessarily poor care. And the fact that Medicare likes them moved out as soon as possible, so doctors and hospitals can be caught in the middle. You could be causing more problems.
Well it looks like this program coming in Oct will make hospitals accountable. They will get tired of paying and want to start receiving rewards after a few fines. If a person makes more than one visit for the same problem the hospital will have to find out why. If a person is readmitted for something else then hospital is not fined for this. It will take time to work out the bugs but it will be better for the medicare program in the long run. There are millions of dollars bled out of the medicare program and this will recoup some of it. I believe its a good thing for all, including you.
It’s a direct result of Obamacare. http://www.kaiserhealthnews.org/Stories/2011/March/31/ACO-rules.aspx
Get your facts right before you post.
time will prove me right, the hospitals that provide the most help to the poorest among us are the ones being penalized under a heavy handed beurocracy that wields power blindly and the sheep go along willingly telling me to get my facts straight? I suggest you walk through an ER in any of our local communities and see first hand what is going on,but i guess you would have to get off your high horse to do that,don’t let facts get in the way of your opinion.
I actually work in the healthcare field. I’m well aware of what goes on. I have to deal with the “heavy handed beurocracy” every day. You sound angry. Why don’t you go get some healthcare yourself?
in the business,huh? you should be a democrat pundit.Short insults,no facts and a condescending attitude. as far as angry goes, i am just cranky,hence the name.The only cure for me would be for the country to start having an honest discussion on the problems facing all of us and not defending your respective political parties for the sake of getting or retaining power.
Back in the 80s when I was giving birth to one of my children there was a
young couple who had health insurance coverage under an HMO that rewarded those who didn’t stay for the physician/medical recommended number of days and penalized those who did.
My insurance, also an HMO covered the recommended stay of 3 days. The young couple
stayed 12 hours….. I hemorrhaged 15 hours after the birth of my child
and needed transfusions …. HMOs started this, health care decisions were taken from physicians and given to business people who were looking at profits.
the same thing happened to my wife and I. Fortunately we didn’t have the results that you did, but there is no way a woman is ready to take care of a child unassisted within 12 hours of giving birth. Recovery time is essential for a good recovery. I believe that having someone that needs to be in a hospital should be there until they don’t need to be anymore, and not kicked out before they are able to take care of themselves. Sadly it happens all the time.
i am glad you got the help you needed,my mom went thru something similar in the early 80’s,only she lost the baby during labor.my wife and i had trouble during the birth of our daughter that required far more than a normal delivery. can’t blame anyone.as far as HMO’s go, Ted Kennedy was one of the creators of them,as a payoff to the insurance lobby,now people seem to be asking for something exponentially worse while telling themselves it will be better under gov’t. control.
Wow. One percent does not sound like much, but hospitals are going to be hurt dearly. Then you know who is going to pay in the end. You and me.
Stop letting the conservative elite tell you that you should pay.
tinyurl.com/cyk9xz2
Works for me. In this day in age all the hospitals care about is: 1. getting the patient out as fast as possible 2. minimal discharge planning 3. minimal follow up and of course 4. their MONEY. There is clearly an issue if people are allegedly cleared for medical discharge and who are then readmitted within a month….why should this be acceptable treatment for anyone? You’re paying for a service and the service is less then successful. If you were to take your car to the garage to get the alternator fixed and within a month your alternator isn’t working again you’d be heading back to that garage to have them correctly fix your car at their expense.
We both agree that readmissions are unacceptable. That said, it gets real tricky from there: if you have a patient discharged with clear instructions to take medication(s) and that patient fails to take the medication and as a consequence requires readmission, whose to blame? Further, consider that a hospital that has high morbidity rates might also score higher on readmission rates – after all a dead patient won’t require readmission.
I agree that hospitals need to do more with coordinated care and strategies for followup, but as always, how the patient takes care of themselves is a large part of the mix.
I agree the patient is an important piece of the equation…My 80 year old mother was recently discharged from a hospital. I attended the discharge meeting. At the meeting initially there was no discharge plan made for when she returned home….no appointments made, no follow up, no referrals, no coordinated care.. nothing… they told her she could make all the appointments and figure out what she was going to need….and that was when I said ‘no I don’t think so’…so before the meeting was over they had community nursing set up, her appointments to her specialists were made, coordinated care was completed and she had appointments made for any follow up. My mother’s not a medical professional and would have been lost with who to call and for what. To me that was completely unacceptable and having worked in a hospital and having done discharge planning I knew better and so did they after that meeting.
Good for you, in following up and letting them know where they failed.
You are being too modest. You were a huge part of the equation here. Not everyone has the experience and the ability to speak up and advocate for their patient this way. And not all patients are fortunate enough to have a daughter like you living locally to them who can be involved.
Should we blame your mom because she’s a regular person who is already sick and isn’t sure how to follow up on her own? No. But some here would I think. Your story is a great example of how hard it can be for any of us when we are at our most vulnerable to navigate the medical system and advocate for ourselves.
This move to penalize hospitals may be problematic, but if it gets more people thinking about how to send people home safely with the tools they need to get better, it possibly could come to a good thing.
The other issue is for people that may not have the resources or family support to follow up on what they are told to do. In Maine I think it might even be worse, and for older relatives who are prideful and don’t want to admit that they are short of money to fill a prescription, or lack people in their lives to help them get to a medical appointment following instructions may be very hard.
I know several people right now, good folks, that would rather keel over dead than admit they might not be able to do something for themselves, that their relatives weren’t supportive, or that they might be short on funds choosing between heating oil, food and medicine. If you asked them why they didn’t take their meds or make an appointment and it was because they didn’t have money for medicine or gas they’d just stubborn up on you and stonewall. Then they’d get blamed for not doing their part…and that would just make them even more stubborn and they’d not admit why ever.
Getting this stuff out into the open is important. If follow on care was seen as the responsible norm, rahter than some charity thing or a burden, people could honestly let people know what they needed and how much help they could use. Outcomes would improve.
But its just plain mean spirited to blame a sick person, or the elderly, for not doing their part when the rest of us haven’t taken the trouble to respectfully find out whether we’ve asked them to do something that is personally impossible for them to accomplish. Doing that is the real death panel and we’d all be guilty of sitting on it.
When a patient is discharged from a hospital on 18 different medications, and cannot tell her primary doctor WHY she is taking 10 of them, nothing on the bottle label to indicate what the drug is for, nothing in the written list of medications she was handed at discharge – whose fault? Look up “doctor” in the dictionary. It doesn’t mean “healer”, it comes from a Latin word meaning “teacher”. If the doctor is so smart (and the patient, btw, had an 8th grade education) he/she SHOULD be able to find words to explain to this woman, and her 10th grade-educated daughter trying to help her, what the medicines are for. It dereliction of duty not to write down the reason for the patient to take the drug!! Suppose she decides she can’t AFFORD all 18, and wants to eliminate a few. Suppose she drops the drug that stabilizes her heart rhythm, instead of the one for acid reflux. Now readmitted to the hospital in heart failure that need not have occurred, who’s responsible? The doctor, the agent of the hospital in this case, screwed up!! Why shouldn’t the medical system be penalized?
I’m not sure what hospital or where you work, but we, from day 1, are planning for safe discharge and that includes, medications (the ability to afford them, substituting an equivalent lower cost product, and education), follow-up care, including labs, PT, OT, speech, nursing etc..not to mention obtaining equiptment needs. We also will coordinate and obtain a PCP for someone who needs one. We are not only educating the patient, but family memebers as well. For the record, we were not on the list.
You seem passionate about your profession…I hope you can find the right fit in an institution. I hope you continue to empower and educate your patients.
Please don’t think I’m blaming any ‘sick person.’ My 80 year old mother was and still is a ‘sick person.’ My issue is with the specific ‘professional’ medical people who I have encountered who are either too worried about their bottom line (i.e. MONEY) and clearly not the person or are too LAZY to DO THEIR JOBS.
My point being that when my mother get’s discharged from a local Bangor hospital at the cost of well over $1800.00 a day and they try to shlep off making ANY care coordination discharge plans for her (post discharge) and she still has an open leg wound and has Diabetes II (among a myriad of other medical issues) that’s not going to fly, at least not with me. I kind of EXPECT the ‘professionals’ providing the treatment for her to DO THEIR JOBS. I know it’s a crazy concept, but I’m not willing to expect or accept less for my mother’s treatment or care….and they can take THAT to the bank every single time.
This is a lose-lose situation. Insurance companies (Medicare included) have been trying to dictate care from their financial offices for many years now. Refusing to pay for what they consider unnecessary medical treatment & forcing doctors to go against their medical training & treat conservatively. This conservative care has lead to rehospitalizations, undiagnosed illnesses & now Medicare is going to punish hospitals for doing exactly as they were forced to do. Also, unfortunately, there is a population who are noncompliant after discharge & become frequent flyers because they will not take responsibility for their own health. We are all screwed medically & it will only get worse.
All the Maine hospitals that supported Obamacare need to ask themselves — how’s that “Hope and Change” working out for them, now?
Lose lose unless you are a patient. Maybe you “pro life” people should start acting like life is as important as a doctors third benz. Doctors and hospitals have been untouchable long enough. Time for them to stop being lazy and do their jobs.
WWW, I know one thing for certain. You are not a primary care physician who admits patients to any hospital. I am, so you might want to grant that I know of what I write. Readmission within 30 days is a scandal going on long before the Prez was elected to the Senate!! Do you really think that you, as a tax payer, should PAY AGAIN a hospital to take care of a Medicare beneficiary who spends 7-10 days in the hospital, then because of poor discharge instructions, no coordination of care, carelessness on the part of the hospital to send records to the primary doctor, NO primary doctor (because the Emergency Medical Treatment and Active Labor Act, while requiring the hospital to stabilize the patient’s emergency condition, makes NO provision for follow-up care) is readmitted? Do you think you as a taxpayer should pay doctors & hospitals when patients get infections because no one bothered to figure out how long a bladder catheter had been in place, and when it should be removed? Should you pay for treatment of bedsores because no one turned the patient? Should you pay for the same 36 test blood panel ordered by the consultant because he neglected to review the chart, where he would have found the results from the same test ordered by the attending? Do you want to pay hot-shot cowboy cardiologists who put a stent in any vessel they can find, even though there is NO scientific or medical proof that the very expensive procedure will do anything to prolong the patient’s life? How about replacing an 80 year old man’s arthritic hip, after the oncologist has diagnosed prostate cancer metastatic to bone & given a 6 month life expectancy? Is that money (yours) well spent, or a “death panel” at work? What if said 80 year old also has advancing dementia? The horrendous waste in US health “system” has nothing to do with the political party of the current president.
I wish you would post more often. You seem to be someone we should really be listening to.
(I’d like to invite you to sign up for As Maine Goes…….we’re alway looking for bright, knowledgeable, iconclastic posters).
If this is your first post i’m waiting for more. Keep on talking and talking and talking. There are so many that have no business speaking at all about this and when they do they just spew lie after lie after lie. Your candor and honesty will open the eyes of the ones that have been bamboozled. Im not seeing any negative comments about what you said, hard to dispute the truth when it slaps you in the head.
Some of those readmissions have nothing to do with the reason for the original hospitalization but the law does not allow that argument. Patients who are ill enough to be hospitalized in this day and age for a week to ten days are usually not there for some kind of easy fix. Unfortunately they may have other conditions which require attention. Hospitals do MILK the system getting every possible test done just to get that expensive equipment paid for, but this has nothing to do with the law regarding readmissions. Poor care is evident, but why isn’t the hospital staff properly supervised. By fining for readmission, patients on medicare will once again be subject to minimal care and our seniors deserve much better.
I recently had two seperate medical procedures performed. One less complicated; was performed in the OR in an Eastern Maine hospital (one on the list of hospitals being “fined”)the other, a more serious surgery; was performed in Portland. One thing that really stands out in my mind is that in Portland; there was extra attention paid to the prevention of “hospital aquired” infections.There I was swabbed and tested for MRSA and VRE upon arrival to the OR suite. After my surgery, there were “single use” disposable blood pressure cuffs and inflateable booties to prevent the formation of blood clots. The differance between the two facilities was very apparent. The Portland hospital had a very proactive plan in place for infection control. perhaps this is a part of the reason they did not make “the list”?
MMC does work very hard to prevent infections, but any person who is going into the hosptial electively (who can plan ahead) should have their MRSA test done at least 2 weeks prior to admission. Then if you ar epostiive and are having a risky procedure done, you can prepare with decolonization if you have a positive test.
Thank you for your candid and accurate response. All of the things you say are accurate and right on. We CAN reduce the readmission rates with the right steps.
I’m not sure but I think you and Whine are in agreement only you viewed the problem from different angles. Regardless, I think you did a great job of identifying just a few of the problems that are the result of a “for profit” medical system. No, I am not a physician however my primary care doctor agrees with me when I say we need a universal healthcare system and we need it now.
You make some very valid points. What about the non-compliant CHF, or COPD patients that are readmitted within a month. What about drug/alcohol/suicidal ideation re-admissions? Should the hospitals be penalized for people that refuse to take responsibility for themselves? Or more importantly, ones that cannot do so.
In my opinion this act will affect the AMA hard down the road. The U.S. Government has been looking for a way to do this for a long time.
Having said that, I would refer you to “Sick around the world” and “Sick across America.”
They are documentaries that are well worth the time watching.
You are 100% correct in your statement. Several members of my family are medical/healthcare professionals and they frequently express concern about the two significat aspects of medical care that you cited: 1. financial/insurance limits on the length of hospitalization that result in premature discharge and 2. patients who don’t follow post-discharge instructions.
People need to be cared for once out of the hospital also.
wait for it…thousand three-thousand two-thousand one-……Lawsuit for..’something, something disapportionatley affecting lower income or minorities”….
following post visit orders (as was said, medications, resting, etc) is crucial to not being re-admitted. There should be some responsibility for those who don’t follow orders. And those hospitals who don’t take the apporpriate time with these patients, the readmission should be on their dime…
you know i have been diagnosed with right diastolic heart failure and diabetes type 2 plus an issue that has yet to be diagnosed on why my platelet count count is falling off. what they are saying is not fair. though it explains to me why EMMC doesnt like to redadmit me or getting fired by providers . it isnt entirely my fault. part of my problem is i have trouble trusting and i am scared . the patients that do well are the ones that have 100% family support and i dont tht is my problem. the doctors and nurses who treat me dont understand i am scared they either fire me as a patient or i dont get the care i really need
You’re right Mr. Willette it is not your fault. Eastern Area Agency on Aging could perhaps assist you is finding some support in your area their number is 1-800-432-7812 and their web is:
http://www.eaaa.org I hope this helps.
they arent family . it is always nice to have family supporting you. come to visit you . advocate for you. there is nothing like having blood family. you go into a icu waiting room. usually it is full of family members that is what helps in a patients recovery
Davida, from your facebook photo I would say part of your problem is weight. Is that the fault of the hospital??
Your doctors’ failures are being blamed on insurance. They need to start taking responsibility for their actions. As a contractor I cannot blame osha and then fail to deliver a promised good to my client. I can’t say well osha says I need a mask to stain your deck so I won’t do it. Someone who doesn’t know their deck needs to be sealed will suffer a deteriorated deck and need to repair it when I should have done my job in the first place. Doctors fool people into thinking that their work is really not their own so they are not responsible. How nice would that be? Have a doctors salary without responsibility.
Seriously, I see new homes in the future adding a sick room, with o2, hospital bed and computer able to communicate with the doctors. Testing will be done at a testing center, these huge gigantic hospitals, are way too much to maintain and the one thing that we may have to resolve, is the new hips, knees, hearts, livers, will be for those who have the cash. But, in the 50’s and 60’s, when I was a kid, there were none of these things, people accepted their fate, those with bad hearts usually drank themselves to the end, knees and hips, canes and aspirin, I am not sure but we have gone too far in some respects.
it is almost always better for the patient to be kept in the hospital too long then not long enough.
This new plan will make it better for the hospitals to keep you as well and will reward those hospitals that are doing the best job.
Its always better to get out and moving as soon as possible.
True as soon as possible but not so soon you end up back in the hospital having reaggravated the problem
In some cases Lord Whiteman you are right, but the longer the hospital stay, the more of a chance of getting a hospital -born infection.
Yes this is a big problem world wide and I personally wouldn’t want to stay in a hospital any longer then needed anyway.
However people should only be sent home on the best advice of their doctors and not because the insurance companies profits are off this quarter.
Cannot argue with you there.
The reason they have to re-admit people is because they send them home too soon. That too is done to satisfy standards- they must do it or not be reimbersed for extra days spent in hospital. It is a no win sitruation & I have often wished that those who make up these stupid rules had to go thru some of the illnesses that they are so quick to set guidelines for.
There could be reasons for readmissions that have nothing to do with greed per se. How many readmissions are due to people who leave against medical advice and then need to return when they get sick? I once had to leave the hospital AMA to take care of personal business because none of my family and friends were able to assist me due to time and distance. The hospital had refused to give me a three hour pass because they were concerned about their liability, despite my assurances that I was taking responsibility for myself during the 3 hours I would be gone, and that I would return immediately after taking care of my personal business. Also, insurance companies put pressures of hospitals to discharge people to reduce costs, even though premature discharges don’t save a dime and probably cost more in the end.
These hospitals should be penalized, and HARD. This is a disgracce.
So if a hospital has a low readmission rate due to deaths they won’t be penalized?
What’s a person to do if he gets sick and admitted every month? The ER’s are getting savy with this medicare thing. I was recently taken to ER by an ambulance. I laid there for 8 hours collecting dust while they figured out what to do with me; whey my problem got worse they decided to admit me. You have to be in a life-threatening situation to be admitted, unlike the old days where they would give you the option of going home or staying overnight.
This is one way Obama is already rationing care for the poor, old and infirm. If you are rehospitalized for any reason within a month of being hospitalized, the hospital will be penalized so they have great incentive to turn you away at the door. Thanks, Obama!
Where does patient responsibility come into play? If a patient is admitted, told what to do to improve their health, and disregards the medical advice how is that the fault of healthcare? This is only going to cause hospitals to decide NOT to admit “frequent flyers”. They will then die, which will lessen the social burden. Socialized medicine’s dirty little secret.
They will reward hospitals that do the job that their supposed to do. Why not give it back to the taxpayers for being good taxpayers.
Although this article does not say it, many hospital readmissions are because of infections that patients acquired while hospitalized, and because of complications of care they received during their first hospitalization. Other reasons that patients are readmitted is because of poor instructions and coordination of post hospital care, inability to get prescription medications or go to prescribed therapy. Care management is a huge help in preventing readmission.
I work in a health center, and I see patient noncompliance every day, not to mention straight out abuse of the health system. Even worse than that are the people who go to the hospital whenever they are bored, lonely, or drunk…some people have to be put into new (paper) charts multiple times per year. When asked if I could report them to Maine Care, I’m told that because they have a legitimate, on the books condition, there is nothing we can do…
Pushing a “for profit” based system to perform better is at odds with the “for profit” motive. We need universal healthcare now!
Medicare has been so devastated by Congress – because members of Congress believe themselves to be a powerful, elite group of people better than everyonne else. THEY don’t participate in Medicare, therefore they have no vested interest in improving it – just using it as a political football on BOTH sides of the aisle. Just like Social Security, Congress has no vested interest in improving it because THEY are the RULING class and We, The People are now nothing more than serfs to an economic feudalist state.