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Union Hospital Sees $400,000 Medicare Loss From Readmits

Some Indiana hospitals are losing Medicare funding because of the rate at which people are readmitted after treatment.

hospital bed

Photo: Nathan and Jenny (Flickr)

Hospitals aim to reduce re-admits because they receive more Medicare funding for good performance.

Some local hospitals will soon lose money because too many of their Medicare patients are readmitted for treatment within 30 days of being discharged from their initial stay.

Medicare recently began a new data collection period, but this time with teeth. Hospitals whose heart attack, heart failure and pneumonia patients come back too soon or too often will now cost the hospitals money if the readmission rate is worse than the national average.

For Columbus Regional Hospital, it is not a big concern, says Chief Medical Officer Tom Sonderman.

“We are not anticipating any kind of deduct in payment for this first session,” he says. “We are actually doing better than expected and are doing better than the national average.”

But it is a different story for Union Hospital in Terre Haute.

“We’re looking at around $400,000,” says Utilization Management Manager Lori Horrall, who says many of her hospital’s readmissions happen soon after a patient is discharged…

“About 40 percent of our congestive heart failure patients, if they’re going to be readmitted, come back within those first seven days,” she says.

Union Hospital has tasked a nurse with following up with those heart failure patients.  If readmission rates shrink, nurses may also begin checking in with pneumonia and heart attack patients, too.

Both hospitals say the key to reducing the readmission rates and, by extension, any fines they incur is better communication with patients after they leave a doctor’s care. It is part of a larger push by hospitals to eliminate a perverse incentive, because the more times a person sees a doctor, the more a hospital makes.  But expert say that does not necessarily equate to better care.

Stan Jastrzebski

WFIU/WTIU News Senior Editor Stan Jastrzebski spent time as a reporter with WGN Radio in Chicago and as an editor at Network Indiana, an Indianapolis news service. Stan is the winner of awards from the Associated Press, the RTDNA, the Indiana Broadcasters Association and the Society of Professional Journalists. He hosts WFIU's Ask the Mayor and anchors WTIU's InFocus.

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