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Readmission Penalties Showing Positive Results

The ACA began the readmission penalty program in October 2012, when patients who were readmitted within 30 days of discharge caused the CMS to withhold up to one percent of reimbursements for hospitals. One year later, the penalties increased up to a maximum of two percent. According to recent data reported from the CMS, hospitals are reporting their readmission rates are decreasing.

49 states and Washington D.C. have reported progress since the start of the new reimbursement penalties; 30-day readmission rates for Medicare patients fell below 18 percent in 2013. CMS says about 130,000 readmissions may have been prevented between January 2012 and August 2013. A more collaborative approach by the care providers has contributed to the shift to improving quality healthcare services in hospitals and decreasing readmission rates. Analysts wonder if this trend will continue or if readmission rates will flatten out after the initial implementation wears off.

Do you think readmission penalties are working? Will the readmission rates decrease even more or will they stay the same?

Read more and share your comments.

Specialty Spotlight
Hospitalists Will Receive Less Reimbursement for Treating Poor SeniorsSpecialty Spotlight

Dual-eligible patients (having both Medicare and Medicaid) are more likely to be readmitted to the hospital, according to a new study. Readmissions incur penalties by the CMS, which decrease the reimbursement payments hospitals can expect to receive. The U.S. Department of Health and Human Services is attempting to convene a panel to analyze different reimbursement penalty factors.

Read the article.

Should Pregnant Women Employed in Healthcare Settings be Forced to Get the Flu Shot?

This flu season has been particularly brutal, starting earlier and affecting more Americans than usual, with some states even reporting deaths due to influenza already. A pregnant nurse in Pennsylvania made national headlines recently when she was fired for refusing a mandatory flu vaccination. The CDC urges all healthcare providers and staff to get the flu shot each season, and the hospital at which this nurse was employed requires employees to abide by the CDC's advice. Though the CDC says the flu shot actually protects pregnant women and their babies who are more susceptible to the flu, the nurse has a history of miscarriages and worried the shot could trigger another one.

In The News
Providers and Healthcare Organizations Unprepared for ICD-10

Although the majority of healthcare payers and providers have completed an ICD-10 impact assessment and budgeted for the implementation, they are unprepared for the financial impacts, according to a recent survey by KPMG, an audit, tax and advisory firm. 73 percent of survey respondents understand the transition will have a moderate to severe impact on their organization, but 74 percent said they have yet to or are not planning on conducting testing that involves external entities. This could cause tremendous problems as the transition to ICD-10 looms closer.

Will you be prepared for the ICD-10 implementation?

Read the survey results and share your comments with us.

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