Hospitals, Doctors Consider Changes Amid Medicare Hospital Readmissions Scrutiny

Hospitals and doctors are feeling the health care law heat as officials try to reduce readmissions and increase quality of care in the Medicare program. PBS NewsHour looks at the law's hospital readmissions penalties and Medpage Today explains what the hospitals are doing.

PBS NewsHour: Health Care Law Aims To Reduce Need To Rehospitalize Medicare Patients (Video)
Every year, nearly 2 million Medicare beneficiaries are readmitted to the hospital within 30 days of being discharged, at a cost of $17.5 billion. Health correspondent Betty Ann Bowser reports on provisions in the new health care law that aim to limit the need to rehospitalize Medicare patients (6/28).

PBS NewsHour: Health Reform Brings Heavy Fines for Hospitals With High Readmissions
The federal government began fining hospitals based on how many Medicare patients were readmitted within 30 days of discharge in October. They track three specific conditions -- heart failure, congestive heart failure and pneumonia. … [W]e spoke to Kaiser Health News reporter Jordan Rau recently. He's been following the policy since the Affordable Care Act was passed in 2009 (Clune, 6/27).

Medpage Today: Hospitals Already Feeling ACA Pinch
Putting the Affordable Care Act (ACA) into practice has left some hospital-based physicians feeling trapped between two worlds. Although most care is still delivered in the fee-for-service realm, many have started to think in terms of a pay-for-performance model, with a focus on improving outcomes while simultaneously trying to make care cheaper. … A triumvirate of ACA reforms is driving most of the changes that serve an ultimate goal of improving outcomes in order to lower costs. These are reducing readmissions, diminishing hospital-acquired infections, and getting paid based on the value of service provided (Fiore, 6/28).

And Sen. Charles Grassley asks states what they're doing about problem doctors who serve Medicare patients --

ProPublica: Senator Asks States If They Alert Medicare To Problem Physicians
A key U.S. senator sent letters to all 50 states this week asking how they sanction doctors in their state health programs and whether they alert the federal government when they do.  In his letters, Sen. Charles Grassley, R-Iowa, cited examples from a ProPublica report last month that found doctors who had been kicked out of state Medicaid programs for the poor were able to continue prescribing drugs to elderly and disabled patients in Medicare (Ornstei, Weber and LaFleur, 6/28).

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