University of Missouri, Department of Medicine, Division of Hospital Medicine
Abstract
Hospital readmissions are under scrutiny in the context of health care delivery and payment reform. Hospital readmission rates for Medicare (CMS) patients with principal diagnoses of heart attack, heart failure and pneumonia are published to the consumer-focused Hospital Compare site as an "outcome of care" for hospitals participating in the InpatientQuality Reporting program. The CMS Hospital Readmissions Reduction Prorgam will first affect Medicare payment in federal fiscal year 2013. In year one, the focus is 30-day readmissions of patients with heart attack, heart failure and pneumonia. Hospitals with higher-than-predicted readmission rates between July 1, 2008, and June 30, 2011, will be subject to as much as a 1 percent payment reduction (1 percent reduction in base operating DRG payment amount for Medicare Fee for Service patients aged 65 or older) in October, 2012
