Obamacare imposes arbitrary rules on hospitals
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. . . .