Kingston, New York Medical Malpractice Lawyer Astonished By How Much Hospital Readmissions Cost New York; You Will Too!

A report by the New York State Health Foundation released a report this week finding that hospital readmissions costs New York $3.7 billion per year! In fact, this translates to nearly 15% of all initial hospital stays resulting in a readmission, or an additional 274,000! Essentially, a hospital readmission is when a patient returns to the hospital within 30 days of the initial hospital stay for further treatment.

The report further broke down some of the details. It noted that approximately 4% of all initial hospital stays resulted in a readmission related to complications or infections which costs New York about $1.3 billion each year; this accounts for nearly 6% of the total hospital costs. Specifically by the type of stay, 66.8% of all readmissions were for medical reasons, 19.2% for surgical reasons, 12.1% for behavioral health reasons, and 1.9% for maternity reasons. The vast majority of all readmissions, 52.4%, were for individuals who were 65 years or older. The region with the highest rates of hospital readmission rates was New York City, but all of the other regions-including the Capital Region-had an annual readmission rate of at least 13.6%.

President and CEO of NYSHealth, James R. Knickman, remarked that “Hospital readmissions are a key indicator of health care quality and, as we see in this report, a key driver of health care costs.” He continued that “[i]n New York, high readmission rates are not an isolated problem at just one or two hospitals. They are common and costly to every region of the State.” This is not the first time that New York has been criticized for having high readmission rates though. In 2009, another study ranked New York 29th on 30-day hospital readmission rates for Medicare patients.

Recently, I have written a few posts regarding the quality of health care. While readmissions are not the most clear-cut indicator, even though President Knickman believes so, it is certainly influential. The report suggests that payment incentives can help reduce readmissions and costs, but how could that possibly be implemented in New York-particularly with the fog-of-war regarding the Affordable Care Act provisions which will most likely be tested within the coming year in the Supreme Court. The report notes that there should be an incentive/decentive system in place to help combat hospital admissions. That hospitals would face a reduction in payments for higher readmissions rates, and an incentive for keeping their rates low. This is a laudable suggestion, but entirely burdensome to implement and certainly more costly to enforce. When individuals come into hospitals, they are paid either as part of a diagnosis-related group (DRG), which pays per condition, or through some kind of capitation hybrid with insurance and Medicare or Medicaid. If hospitals were paid more initially for the initial visit, they would have less incentive to-essentially-get rid of the patient as fast as they can. Therefore, the patient could stay longer, get better treatment, and if an incident arises that would have resulted in a readmission, the patient is still there for treatment. In the long haul, this may help reduce the $3.7 billion costs that readmissions cost our state but paying a little bit more money initially to hospitals.

If you are interested, please review the report, “Reducing Hospital Readmissions in New York State: A Simulation Analysis of Alternative Payment Incentives,” available at http://www.nyshealthfoundation.org/userfiles/NYSHF_Mathematica%20Final_v5.pdf. I’d love to hear what you think. I welcome your phone call on my toll-free cell at 1-866-889-6882 or you can drop me an e-mail at jfisher@fishermalpracticelaw.com . You are always welcome to request my FREE book, The Seven Deadly Mistakes of Malpractice Victims, at the home page of my website at www.protectingpatientrights.com.