CMS will be including socioeconomic status when penalizing hospitals for excess readmissions within 30-days of discharge from hospital. the socioeconomic status will be determined by calculating the percentage of population seen at a hospital that are dual eligible (both Medicaid and Medicare). See here for the details.
There is hope that this adjustment will allow hospitals that take care of very sick patients but also socioeconomically disadvantage populations will find a more even playing field when competing with hospitals that serve relatively wealthier populations.
It is a no brainer that patients with strong support systems, easy and quick access to their primary care provider, and high health literacy are less likely to be readmitted as compared to patients who lack these factors. Often, poor support system, poverty, lack of primary care access, and limited health literacy go hand in hand. These disadvantaged patients are most difficult to treat and are higher risk of disease-related and treatment-related complications.
Now Maddox et al has calculated which hospitals are likely to benefit and how large the benefit is going to be. They found that hospitals in the lowest quintile of dual enrollment (that is hospitals in the relatively wealthier neighborhoods) saw an increase of $12.3 million in penalties, while those in the highest quintile of dual enrollment (serving disadvantaged populations) saw a decrease of $22.4 million. Large hospitals, teaching hospitals, hospitals in the most disadvantaged neighborhoods, and those with the highest proportion of beneficiaries with disabilities were markedly more likely to see a reduction in penalties, as were hospitals in states with higher Medicaid eligibility cutoffs.
No comments:
Post a Comment