Hospitals Are Punished over Readmissions; Barnes-Jewish Gets the Maximum Penalty, Which Cuts Certain Medicare Payments by about $2.2 Million

Article excerpt

Barnes-Jewish Hospital is being issued a multimillion-dollar penalty by the federal Medicare system for its poor readmission rates.

The hospital estimates that the penalty will amount to about $2.2 million. Barnes has struggled for some time to reduce readmissions, defined as patients being rehospitalized within 30 days for certain conditions.

"I view this as a multimillion-dollar issue for us over the next few years," said Dr. John Lynch, the hospital's medical director. "We're not giving up. We keep trying to improve our discharge process and mount a gallant effort to connect patients with their medical homes."

The penalty amounts to a 1 percent reduction of certain Medicare payments to the hospital - the maximum penalty this year under the new federal rules. Hospitals that have higher-than-average readmission rates could face up to 3 percent penalties in their Medicare payments in the next few years.

The federal government recently started using readmissions data as a key measure of hospital quality. According to Kaiser Health News, 2,211 hospitals throughout the United States are being penalized under the federal health reform law for a total of $280 million.

Twenty-four of 30 hospitals in the St. Louis area, including the Metro East, are being penalized by the federal Centers for Medicare & Medicaid Services.

In the St. Louis area, the penalties range on the low side from .06 percent for St. Louis University Hospital to .80 percent for Mercy Hospital St. Louis in Creve Coeur. Only one other St. Louis area hospital besides Barnes-Jewish is being hit with a maximum, 1 percent penalty: SSM DePaul Health Center in Bridgeton.

"It's important to note that not all readmissions are bad and in many cases are medically appropriate," Dr. Kevin Johnson, a regional vice president for SSM Health Care - St. Louis, said in a written statement. "However, oftentimes things like socioeconomic factors have a huge impact on readmission rates and are issues outside the control of the hospital."

He said the SSM system is developing programs "to bridge the gap between hospital discharge instructions and the care people receive in the community."

Mercy Hospital declined to comment about its penalty or its Medicare payments.

Barnes-Jewish, the flagship of nonprofit BJC Healthcare, has one of the highest readmission rates in the United States. Compared with other hospitals, its Medicare patients have a greater likelihood of being rehospitalized within 30 days after being treated for a heart attack, heart failure or pneumonia. …


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