Local hospitals face Medicare cuts
By Janet Lundquist firstname.lastname@example.org September 19, 2012 10:40PM
Updated: October 21, 2012 1:54PM
Starting next month, Medicare will cut federal reimbursements for hospitals that have, according to government calculations, too many patients readmitted soon after they are released.
Silver Cross Hospital in New Lenox, Provena Saint Joseph Medical Center in Joliet and Adventist Bolingbrook Hospital each face a 1 percent cut in Medicare reimbursements because of their patient readmission rates.
The Center for Medicare and Medicaid Services defines readmission as a patient being readmitted within 30 days of discharge, and determined the amount of Medicare reimbursement cuts on its analysis of each hospital’s statistics.
A report by Kaiser Health News from Aug. 13 states 19 hospitals in Illinois are facing the 1 percent funding cut, the maximum allowed under the 2010 Affordable Care Act.
A spokeswoman for Silver Cross Hospital said the cuts are based on old statistics.
“Silver Cross Hospital continuously works to improve patient care,” hospital spokeswoman Tracy Simons said in an email. “The cuts that Medicare is making are based on 2009 data. Since that time, we have significantly reduced readmission rates with the help of the medical staff and expect the cuts to decline in the future.”
Rick Mace, chief executive officer of Adventist Bolingbrook Hospital, said in a written statement that a primary focus is on patients with chronic conditions, such as diabetes, because they are the ones most likely to be readmitted.
The hospital’s clinical care team — which includes nurses, doctors, case managers and social workers — determines what post-discharge care a patient will need and educates them on their conditions as well as any follow-up treatment needed, he said.
“Often we also call patients at home after they are discharged to check on their progress,” Mace wrote. “By promoting self-care and self-management of chronic illnesses for this patient population, we hope to not only reduce unnecessary re-admissions but also improve their quality of life.”
Addressing the issue of preventable readmissions is a high priority, but there are many factors including a patient’s compliance with his or her prescribed treatment plan that can contribute to a need for readmission, said Jan Ciccarelli, a spokeswoman for Provena Saint Joseph Medical Center, in a written statement.
Almost every hospital in Illinois will experience a readmission penalty of some degree, Ciccarelli wrote, and added that Provena Saint Joseph Medical Center and the other hospitals will continue to work diligently to reduce readmissions.