A penalty in the Affordable Care Act on hospitals regarding Medicare patients will work against hospitals and patients alike, say Harvard Medical School professor Stephen Soumerai and University of Pennsylvania sociologist Ross Koppel.
Under Obamacare, hospitals that re-admit "excessive" numbers of Medicare patients within 30 days of discharge confront significant penalties. The maximum penalty is 1 percent of a hospital's Medicare reimbursement, increasing to 3 percent in 2015.
"That may not sound like a lot, but for hospitals already struggling financially — especially those serving the poor — losing 1-3 percent of their Medicare reimbursements could put them out of business," the professors write in
The Wall Street Journal.
"Giving hospitals an incentive to improve the quality of care and reduce the re-hospitalization of patients, thereby lowering Medicare costs, is a worthy goal. But the current approach flies in the face of the best medical science and jeopardizes the health of patients and the bottom line of hospitals."
There are three important points to keep in mind on the issue, Soumerai and Koppel say.
First, "research shows that most readmissions can't be prevented," they write. "Readmissions are often unavoidable consequence of life-threatening complications that can appear after discharge from the hospital."
Second, the penalties will harm patients. That's because hospitals will try to push them to emergency rooms, because that doesn't count as an admission. "But substituting ER services for hospital stays will only increase the chance that patients will deteriorate and return with more complications," the professors say.
Finally, "the policy discriminates against poorer hospitals," they write. "Small and financially struggling hospitals lack the resources to effectively manage their discharged patients at home."
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