Medicare Again Penalizes Half of U.S. Hospitals for Too Many Readmissions

Almost half of the nation’s hospitals will be getting penalized for failing to lower the rate at which patients got readmitted during a three-year period between 2016 and 2019, according to a Nov. 2 report from Kaiser Health News.

According to KHN’s Jordan Rau, the penalties imposed by the Centers for Medicare & Medicaid Services (CMS) “have been calculated using each hospital case history between July 2016 and June 2019, so the flood of coronavirus patients that have swamped hospitals this year were not included.”

The penalties are the ninth annual round of the Hospital Readmissions Reduction Program created as part of the Affordable Care Act’s broader effort to improve quality and lower costs. The fines for failure to meet the criteria set forth by CMS focus on six conditions: heart attack, congestive heart failure, pneumonia, chronic obstructive pulmonary disease (COPD), elective hip and knee replacements, and artery bypass graft surgery—and are based on readmissions between July 2016 through June 2019.