Controlling ER, Hospitals Admissions A Challenge For Medicare

A new study finds that Medicare isn't properly counting people who are released from hospitals and then come back to emergency rooms, while Reuters points out pay-for-performance incentives are aimed at keeping people out of ERs.

Kaiser Health News: Medicare Effort To Cut Readmissions Isn't Counting Patients Who Come Back To ER
A study published Tuesday says Medicare may be missing factors that lead to post-hospital health problems because it isn’t counting many discharged patients who come back to the emergency room but aren’t admitted. ... 54 percent of those visits to the emergency department (ED) did not lead to a readmission and thus would not have shown up in the statistics when Medicare calculated the hospital’s readmission rate. (Rau, 4/9).

Reuters: Insight: Insurers See Promise In Pay-For-Performance Health Plans
Insurers and doctors are testing a way to pay for healthcare that has been more common in the corporate suite than the emergency room - paying for better performance, betting it is the key to controlling runaway costs. Both private insurance plans and Medicare plans in hundreds of locations around the country are using incentives to try to cut healthcare spending and still keep Americans healthy (Humer, 4/9).

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