Medicare is Penalizing Hospitals with the Sickest & Poorest Patients Unfairly

Over the past four years, Medicare has been fining hospitals if too many of their patients are returning within weeks of being released. However, many safety-net hospitals and academic teaching hospitals claim that the fining is unfair because they take of poorer and sicker patients.
Harvard Medical School did research that concluded that some hospitals are being penalized based on the patients they serve. According to a study published in JAMA Internal Medicine, the worst performing hospitals have 50% more patients with less than a high school education than the best performing hospitals. This is significant because many patients who are readmitted to hospitals tend to have multiple chronic illnesses, such as diabetes. Moreover, socioeconomic and clinical characteristics are not included in Medicare’s penalty calculations.
Fundamentally, the hospitals treating the most vulnerable patients are being stripped of their limited resources. According to a spokesman for the CMS, more than 2,600 hospitals will lose a combined $420 million in the fiscal year starting October 1st. The CMS’ chief medical officer, Patrick Conway, says that the agency is looking into the impact of socioeconomic status on the readmissions penalty program. The whole purpose of the program is to lower costs and improve care by incentivizing hospitals to take better care of their patients, especially after they leave the hospital. 

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