My Friday night has been reduced to this........ The pay for performance provision I decided to discuss is the readmissions reduction program. Under section 3025 of the Affordable Care Act, hospitals that are found to have excessive patient readmission rates will be subject to a decrease in Medicare reimbursement. The Center for Medicare and Medicaid Services (CMS) will evaluate patients on a 30-day basis. Hospitals will be evaluated on their readmission rates for patients that are admitted for heart attacks, pneumonia, or heart failure. This pay for performance strategy applies to patients that are admitted to hospitals that currently utilize Medicare or Medicaid. Patients who have planned readmissions or are readmitted for reasons unrelated to their first admittance will not be subject to this provision. It is also important to note that critical access hospitals and post-acute care providers are not included in this provision. It is important to note that is provision is also gradual. During fiscal year 2013, a hospital will not see a reduction of payment by more than 1 percent. This reduction will increase from year to year. After 2014, the CMS reserves the right to expand the list of conditions that are subject to fall under this provision. These may include, but are not limited to, chronic obstructive pulmonary disorder and specific cardiac and vascular surgical procedures.
Posted on: Sat, 19 Oct 2013 01:28:05 +0000
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