Medicare begins fining hospitals for re-admission rates

9:55 PM, Oct 3, 2012   |    comments
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CLEVELAND --  This month, Medicare will begin fining hospitals that have too many patients re-admitted within 30 days after discharge because of complications.

At first, it will only focus on three health issues -- heart attack, heart failure and pneumonia. 

The penalties are part of the Affordable Healthcare Act and meant to improve quality of care and save taxpayer money.

Medicare says about 12 percent of beneficiaries in the hospital are later re-admitted for problems that likely could have been prevented, driving up healthcare costs.

Now hospitals with higher numbers of re-admissions will face a financial penalty.

MetroHealth Medical Center has been preparing for this and expects to be billed.

"Public hospitals like Metrohealth are going to be hit disproportionately by this because we take care of patients that have more need," says Dr. Alice Petrulis.

To help limit the number of re-admissions and overuse of the emergency room by people without insurance, they're hiring nurses to act as health advocates and help patients navigate through the system and their own care.

"We have nurses that act as care coordinators to help those patients with transportation medication any barriers to care," says Dr. Petrulis.

Patients can expect follow-up calls and doctor appointments set up before they leave the hospital. They'll also have a familiar face to call for questions. 

"What we've learned when that doctor-patient relationship is strong, patients don't use the emergency room. They know how to call their doctor."


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