By Howard Portnoy
If you have an aging parent or other elderly relative who is currently hospitalized with chronic heart or lung disease, the good news is he is coming home. The bad news is that he is likely coming home to die. That’s thanks to a strong disincentive for hospitals to readmit chronically ill Medicare patients under a provision of Obamacare.
Called the Hospital Readmissions Reduction Program (Section 3025 of the Affordable Care Act added section 1886(q)), the provision took effect on October 1, 2012 and penalizes hospitals for readmitting patients with one of several high-maintenance conditions — heart failure, heart attack and pneumonia — within 30 days of discharge. Two additional expensive-to-manage illnesses, Chronic Obstructive Pulmonary Disease (COPD) and follow-up treatment for coronary bypass surgery, are scheduled to be phased in this year.
In the view of the Medicare Payment Advisory Commission (MPAC), readmission of Medicare patients with any of these illnesses is an admission — of failure on the part of doctors. The government believes that if the correct treatment were administered during an initial hospital stay, these patients wouldn’t need to return. As a corrective measure, the law imposes a hefty fine on hospitals that readmit chronically ill patients. MPAC estimates that the fines collected will ultimately restore $1 billion to Medicare’s depleted coffers.
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