56 Hospitals Facing Maximum Medicare Readmission Penalties

October 8, 2019

Medicare will cut payments to 2,583 hospitals by anywhere from 0.01 percent to the maximum of 3 percent for excessive readmissions.

Orb Health

As part of the Hospital Readmissions Reduction Program, Medicare will cut payments to 2,583 hospitals by anywhere from 0.01 percent to the maximum of 3 percent for fiscal year 2020.

CMS recently released the results for the eighth year of the program. Fifty-six hospitals face the maximum 3 percent payment cut for every Medicare case during fiscal 2020, which runs Oct. 1 through September 2020, according to an analysis by Kaiser Health News.

You can see the hospitals and read the story here.

These health systems are undoubtedly trying to do the best they can with the resources their budgets will allow.  However, when the laws of physics comes in contact with the overwhelming need of chronic patients then the stark realities of the limitations of care capacity have detrimental effects regardless of the effort level.

This is why Collaborative Virtual Care is so important to extending care capacity as virtual service.  By increasing care capacity and extending care between office visits without requiring additional staff, office space, or out of pocket expenses, emergency utilization dramatically drops (54% reduction in one ACO at a Florida FQHC) as seen in this 2019 Orb health study.  Since approximately 23% of ED visits result in a hospital admission, a dramatic drop in admissions is seen with the reduction in ED utilization as a result of a highly-effective CCM program.