Area Hospitals Face Medicare Readmission Penalties

Area Hospitals Face Medicare Readmission Penalties

Medicare readmission penalties to reimbursements from October 1, 2014 to September 30, 2015.

Four area hospitals face penalties for the number of Medicare patients that check back in within a month after certain conditions and procedures. This is the case for 80% of New York hospitals.

This is the third consecutive year the federal government has cut Medicare reimbursements—up to a 3% maximum. The average penalty in New York State is 0.73%.

Doctor Robert Panzer, Chief Quality Officer at Strong Memorial Hospital, says the hospital is doing better than the average hospital in the state. Strong’s penalty increased only slightly over last year (from 0.13% in 2014 to 0.14% in 2015).

“For the three conditions looked at last year, we were a little above average in some, but not all, those conditions. And this year with 5 conditions to look at, there's more of a chance for a penalty and we were pretty roughly much in the same ball park,” said Panzer.

Until this year, Medicare assessed 3 conditions to determine the penalty rate: heart failure, heart attack, and pneumonia. This year, feds added lung ailments and knee and hip replacements to the list of reviewed procedures.

Dr. Panzer explains that affected the penalty assessed against Highland Hospital.

“Highland is a very high volume hospital for total joint and hip replacements, because that's the location for the Evarts Joint Center. So, Highland has a disproportionately new amount of care being looked at,” said Panzer.

Rochester General Hospital has the highest penalty in the region—at 0.65%. That’s less that the average penalty for the state, but slightly higher than the national average penalty (0.63%).