Medicare To Penalize 2,211 Hospitals For Excess Readmissions
By JORDAN RAU
KHN Staff Writer
AUG 13, 2012
More than 2,000 hospitals — including some nationally recognized ones — will be penalized by the government starting in October because many of their patients are readmitted soon after discharge, new records show.
Together, these hospitals will forfeit about $280 million in Medicare funds over the next year as the government begins a wide-ranging push to start paying health care providers based on the quality of care they provide.
With nearly one in five Medicare patients returning to the hospital within a month of discharge, the government considers readmissions a prime symptom of an overly expensive and uncoordinated health system. Hospitals have had little financial incentive to ensure patients get the care they need once they leave, and in fact they benefit financially when patients don’t recover and return for more treatment.
Maine hospitals among 2,211 to be penalized by Medicare for readmissions
By Jordan Rau, Kaiser Health News
Posted Aug. 13, 2012, at 10:27 a.m.
More than 2,000 hospitals — including some nationally recognized ones — will be penalized by the government starting in October because many of their patients are readmitted soon after discharge, new records show.
Together, these hospitals will forfeit about $280 million in Medicare funds over the next year as the government begins a wide-ranging push to start paying health care providers based on the quality of care they provide.
In Maine, 10 hospitals will be penalized. They are: Penobscot Bay Medical Center in Rockport, Mercy Hospital in Portland, Franklin Memorial Hospital in Farmington, Goodall Hospital in Sanford, Maine Coast Memorial Hospital in Ellsworth, MaineGeneral Medical Center in Augusta, St. Mary’s Regional Medical Center in Lewiston, York Hospital in York, and Brunswick’s Mid Coast Hospital and Parkview Adventist Medical Center.
With nearly one in five Medicare patients returning to the hospital within a month of discharge, the government considers readmissions a prime symptom of an overly expensive and uncoordinated health system. Hospitals have had little financial incentive to ensure patients get the care they need once they leave, and in fact they benefit financially when patients don’t recover and return for more treatment.
Nearly 2 million Medicare beneficiaries are readmitted within 30 days of release each year, costing Medicare $17.5 billion in additional hospital bills. The national average readmission rate has remained steady at slightly above 19 percent for several years, even as many hospitals have worked harder to lower theirs.
The penalties, authorized by the 2010 health care law, are part of a multipronged effort by Medicare to use its financial muscle to force improvements in hospital quality. In a few months, hospitals also will be penalized or rewarded based on how well they adhere to basic standards of care and how patients rated their experiences. Overall, Medicare has decided to penalize around two-thirds of the hospitals whose readmission rates it evaluated, the records show.
The penalties will fall heaviest on hospitals in New Jersey, New York, the District of Columbia, Arkansas, Kentucky, Mississippi, Illinois and Massachusetts, a Kaiser Health News analysis of the records shows. Hospitals that treat the most low-income patients will be hit particularly hard.
A total of 278 hospitals nationally will lose the maximum amount allowed under the health care law: 1 percent of their base Medicare reimbursements. Several of those are top-ranked institutions, including Hackensack University Medical Center in New Jersey, North Shore University Hospital in Manhasset, N.Y. and Beth Israel Deaconess Medical Center in Boston, a teaching hospital of Harvard Medical School.
“A lot of places have put in a lot of work and not seen improvement,” said Dr. Kenneth Sands, senior vice president for quality at Beth Israel. “It is not completely understood what goes into an institution having a high readmission rate and what goes into improving” it.
Sands noted that Beth Israel, like several other hospitals with high readmission rates, also has unusually low mortality rates for its patients, which he says may reflect that the hospital does a good job at swiftly getting ailing patients back and preventing deaths.
Medicare Rises as Prime Election Issue
By ADAM NAGOURNEY
TAMPA, Fla. — With Mitt Romney’s selection of Representative Paul D. Ryan as his running mate, Florida quickly emerged on Monday as a critical test of the nationwide Republican gamble that concerns over the mounting federal debt can blunt potent Democratic attacks on conservative proposals to revamp Medicare.
As Mr. Romney campaigned through Florida on Monday, Democrats greeted him with a barrage of assaults, including a Web advertisement featuring worried elderly voters in this battleground state. The campaign took on a more heated air as President Obama suggested in Iowa that the Republican ticket would “end Medicare as we know it,” a warning echoed in North Carolina by Vice President Joseph R. Biden Jr.
Assailing proposed changes to the retiree health plan is a time-tested line of attack, nowhere more so than here in Florida, where voters 65 and older made up 22 percent of the electorate in the 2008 presidential election. Polls show that a majority of elderly voters nationally oppose changes in Medicare or Social Security, which Mr. Ryan in the past has also proposed altering.
The implications extend beyond Florida. Elderly voters are significant forces in Iowa, New Hampshire, Ohio, and Virginia and Pennsylvania, all states that could help determine the outcome of the election.
Aides to Mr. Obama said they would focus on older voters in those states by spotlighting Mr. Ryan’s proposal, broadly endorsed by Mr. Romney, to make Medicare a choice between private insurance and traditional coverage in the belief that more competition would drive down costs and improve care. Democrats say the plan, under which retirees would get a set amount of money from the government each year to purchase insurance coverage, would lead to higher costs and lower quality care for many retirees.
“I think it should be left alone,” said Lee Berkowitz, 87, a Democrat in North Hollywood, Fla., who voted for Mr. Obama in 2008 but said he has not decided whom to support in November.
Seniors would pay the price of Ryan's plan to overhaul Medicare
Paul Ryan's plan would provide a federal subsidy for people to buy private insurance instead of Medicare. If they want better coverage, they'll have to pay for it.
David Lazarus
Fair criticism? The answer, as Bill Clinton might say, depends on what your definition of "cripple" is.
The Ryan plan has been around for months. It's taken on new heft since Ryan, a conservative congressman from Wisconsin, was tapped over the weekend by Republican presidential candidate Mitt Romney to be his running mate.
President Obama's deputy campaign manager, Stephanie Cutter, said onCBS' "Face the Nation" on Sunday that Ryan's plan "would be the end of Medicare as we know it."
Romney responded during a Florida appearance Monday that he and Ryan "want to make sure that we preserve and protect Medicare." He said of the charges made by the Obama campaign that "it's smear, it's dirt, it's distortion, it's deception, it's dishonesty."
It's also true.
http://www.latimes.com/business/la-fi-lazarus-20120814,7923212,6595104,print.column
Health insurance for South Portland officials debated
City councilors agreed Monday to consider options for phasing out city-funded health insurance for councilors.
SOUTH PORTLAND – City councilors agreed Monday to consider options for phasing out city-funded health insurance for councilors.
It was the council's first public discussion of health insurance since a resident, Albert DiMillo, dropped a lawsuit against the city over the issue in June.
Since 1977, city councilors have had the option to receive health insurance from the city, in addition to the $3,000 annual stipend outlined in the city charter. Some residents and councilors have complained that the option creates inequity because not all councilors receive the benefit.
The city now pays more than $36,000 a year for city councilors' health insurance. If all councilors had family plans, the cost would be more than $100,000.
Pen Bay Healthcare faces deficit
By Stephen Betts, BDN Staff
Posted Aug. 13, 2012, at 7:12 p.m.
ROCKPORT, Maine — A sharp increase in people without insurance is expected to result in the area’s health care system ending the budget year with a deficit.
Through the first nine months of the current budget year — Oct. 1, 2011 through June 30, 2012 — Pen Bay Healthcare said it has provided $3.25 million in free care. That is $837,000 more than the same period a year ago.
The increase is due to both fewer people being covered by the MaineCare program for low-income Mainers as well as fewer people receiving health care coverage through their work, according to Megan Williams, director of communications for Pen Bay Healthcare.
The largest component of Pen Bay Healthcare is Pen Bay Medical Center, the hospital located in Rockport. Other parts of Pen Bay Healthcare are the Quarry Hill retirement center in Camden, the Knox Center for Long Term Care in Rockland, and the Kno-Wal-Lin home health care and hospice.
Pen Bay Healthcare experienced an operating loss of more than $2.9 million through the first nine months of the fiscal year, according to Williams. There were some nonoperating revenues that helped offset some of the losses, but the overall net loss was more than $1 million through June 30. Pen Bay’s overall expenses for that period were about $111 million.
Free care is provided for people who earn up to 225 percent of the federal poverty level. That translates to $22,500 for a single person and $3,960 for every additional person in the family.
There are no plans to cut programs at this time, Williams said.
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