Four CT hospitals earn highest Medicare readmission penalty

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Starting in October, Medicare will begin reducing reimbursements to Griffin Hospital, St. Raphael’s, Masonic Home and Hospital, and Midstate Medical Center by 1% because of high patient readmission rates. Eight CT hospitals – Hartford, Hebrew Home and Hospital, Manchester, Middlesex, Rockville, Sharon, Backus and Windham hospitals – will have no deductions to their Medicare payments due to better readmission rates. The other nineteen CT hospitals will receive varying readmission penalties. Overall CT hospitals ranked 12th highest among states in readmission penalties; no Idaho hospitals received any penalties. There was no significant difference between the highest and lowest performing CT hospitals on levels of uncompensated care or overall margins. Among the four hospitals serving the largest number of CT Medicare patients, Hartford Hospital received no penalty, St. Francis a small penalty (about half the state average), Yale New-Haven a substantial penalty (2.5 times the state average), and St. Raphael’s received the maximum penalty of 1%. St. Raphael’s also relies on Medicare for half of total revenue, more than any other CT hospital. Next year the maximum penalty doubles to 2%, and rises to 3% the year after. Penalties are based on the percent of heart attack, heart failure and pneumonia patients who return to the hospital for any reason within a month. The initiative is part of health reform’s shift away from paying for volume to paying for the quality of care. Soon hospital Medicare reimbursements will also be adjusted based on adherence to basic standards of care and patient experiences of care.