Starting in fiscal year 2012 (October 2011) – as part of the Affordable Care Act of 2010 – hospitals will lose 1% of their total Medicare inpatient payments if certain benchmarks on patient readmissions aren’t achieved within the first 30 days after discharge for three high-risk conditions:
Congestive heart failure
Acute myocardial infarction (AMI)
By fiscal year 2017, the percentage of Medicare payments lost will rise to 2%. The number of conditions covered by these penalties may also be expanded in fiscal year 2013 to include four additional diagnoses – chronic obstructive pulmonary disease (COPD), post-surgical coronary artery bypass graft (CABG), post-surgical percutaneous transluminal angioplasty (PTCA), and other post-surgical vascular conditions.
Needless to say, these regulations have hospitals scrambling to revamp their policies and procedures in order to avoid the penalties, since they could easily wipe out a substantial portion of a hospital’s bottom line and threaten their survival.… Read More