Medicare To Fine Hospitals’ Over Readmitted Patients; Kingston, New York Medical Malpractice Attorney Evaluates


It is no secret that health care costs have soared in the past decade—particularly recently. While most of the discussion reached a steep climax this summer when the Affordable Care Act decision was handed down, there is still a strong undercurrent discussing how to improve health care while lowering health care costs. Some of the most significant costs are the Medicaid and Medicare programs. These are both federal programs, but Medicaid also has state involvement that assists with the implementation of the program.

Starting on Monday, Medicare will now start to FINE hospitals that have too many patients readmitted within 30 days of discharge due to complications. This initiative does stem from the Affordable Care Act provisions which were recently upheld and are a penalty under providers to increase the quality of health care to patients while saving money for taxpayers.

Readmitted patients are considered to be one of the LARGEST causes of health care increases; essentially, you are treating patients twice and sometimes worse off than they would have been if they have been treated properly the first time.

It turns out according to data surveys, approximately two-thirds of the hospitals serving Medicare patients, or some 2,200 facilities, will end up with penalties for too high of a readmitting percentage. There penalties average approximately $125,000 per facility according to the estimates by the government surveys. The hospitals that are in danger were all warned ahead of time and were actually provided information regarding the readmitted patient rates and the possible penalties.

Some health care professionals do not like this policy and say that there are just too many factors not in their control. I agree with that notion, but only to an extent. Some hospitals really do just churn out patients far too quickly which not only helps dehumanize health care, but actually can cause more harm than good. Look at a post from last week regarding a patient who was quickly discharged and died waiting in the lobby for a taxi home. He was actually having a heart attack but was just far too quickly assessed.

I think that this is a good idea, but I am interested to see how it works. You know, in theory some plans work great. However, in practice they are far off the mark. I think this one might be overbroad if over two-thirds of hospitals might be subjected to the penalties. I also do not know how relevant it is to have hospitals get Medicare penalties for all readmitted patients if they are not treating all Medicare patients; it doesn’t seem fair to penalize hospitals for that.

In conclusion, yes this has a laudable goal and is a great idea. But I just hope it is not too broad—already over two-thirds?! Are our hospitals that bad? But what do you think? I would love to hear from you! Leave a comment or I also welcome your phone call on my toll-free cell at 1-866-889-6882 or you can drop me an e-mail at . You are always welcome to request my FREE book, The Seven Deadly Mistakes of Malpractice Victims, at the home page of my website at