Obamacare imposes arbitrary rules on hospitals

Great example of one size fits all government rule.  Research hospitals with more complicated cases and hospitals that specialize in heart failure cases are more likely to have higher 30-day readmission rates.  This seems like a perfect example of the rationing that we will be facing under Obamacare.  OK, so readmissions cost $17.5 billion a year, so? I assume that initial admissions cost a lot of money also.  The question is not just the costs per se, but how successful is the hospitalization.

A provision of ObamaCare is set to punish roughly two-thirds of U.S. hospitals evaluated by Medicare starting this fall over high readmission rates . . .Starting in October, Medicare will reduce reimbursements to hospitals with high 30-day readmission rates -- which refers to patients who return within a month -- by as much as 1 percent. The maximum penalty increases to 2 percent the following year and 3 percent in 2014. Doctors are concerned the penalty is unfair, since sometimes they have to accept patients more than once in a brief period of time but could be penalized for doing so -- even for accepting seniors who are sick. "Among patients with heart failure, hospitals that have higher readmission rates actually have lower mortality rates," said Sunil Kripalani, MD, a professor with Vanderbilt University Medical Center who studies hospital readmissions. "So, which would we rather have -- a hospital readmission or a death?"But according to federal government figures, nearly one in five Medicare patients is readmitted to a hospital within 30 days of release, costing taxpayers an estimated $17.5 billion. "Readmissions has been a low-hanging fruit for Medicare," said Jordan Rau, a staff writer with KHN, an editorially independent program of the non-partisan Kaiser Family Foundation. "They've been very unhappy that about 2 million Medicare beneficiaries are being readmitted every year between 30 days of discharge." . . . But physicians debate whether readmission rates are the best measure of outcomes.Kripalani and some other physicians are concerned that readmissions-based penalties may have a disproportionate effect on research hospitals because they handle large numbers of complex cases. . . .



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