Bioethics Blogs

How Medicare Is Punishing Hospitals That Care For Poor People

Such a no-brainer: If patients who receive care at Hospital A are more likely to get readmitted to the hospital 10, 20 or 30 days after discharge than patients in Hospital B, then Hospital A must be doing something wrong. Perhaps clinicians at that hospital are less adept at diagnosing and managing patients’ problems. Perhaps the follow-up care at Hospital A is less organized, leaving patients’ problems to spin back out of control. Maybe that hospital’s electronic medical record system is fragmented, making it harder for outpatient clinicians to figure out what happened to their patients when they were in the hospital. Whatever the reason for this shoddy care, we shouldn’t stand by and let it happen. Right?

That has certainly been the view in the Medicare office lately, with the Centers for Medicare and Medicaid services (or CMS) reducing payments to hospitals that have excessive 30-day readmission rates. CMS is trying to use its financial clout to motivate healthcare providers to provide higher quality care. The readmission policy is one of many reimbursement changes built into the Affordable Care Act (aka Obamacare).

But it is a policy that probably needs revision. Evidence is continuing to accumulate that the readmission policy will unduly harm hospitals that care for low income patients. (To read the rest of this post and leave comments, please visit Forbes.)

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.