Reprinted with permission from the Times Union
ALBANY – New York hospitals slightly reduced their readmission rates last year, but the state still has the nation’s highest overall 30-day readmission rate, according to a new Kaiser Health News analysis.
Just over 16 percent of patients who were released from New York hospitals wound up back there within a month according to admission data taken from the 12 months ending in June 2017. The Empire Center of New York, a fiscally conservative think tank based in Albany, initially reported the data Thursday.
Since 2012, the Affordable Care Act has authorized Medicare to penalize hospitals with high rates of avoidable readmissions in hopes of encouraging better care and coordination after a patient is discharged. It does this by withholding a percentage of the hospital’s Medicare reimbursement — by as much as 3 percent for the worst offenders.
The Kaiser Health analysis found that 90 percent of New York hospitals will face penalties in 2019, down from 93 percent in 2018. New York has the 12th highest penalty rate among the 50 states and District of Columbia.
The average penalty for New York hospitals will be a 0.85 percent reduction in Medicare reimbursements, down from an average reduction of 0.92 percent one year earlier.
In the greater Capital Region, Columbia Memorial Hospital in Hudson faces the largest penalty, with 0.92 percent of Medicare fees going unpaid. Saratoga Hospital is next with 0.83 percent, followed by St. Mary’s Hospital in Amsterdam at 0.47 percent, Albany Medical Center Hospital at 0.32 percent, Nathan Littauer Hospital in Gloversville at 0.22 percent, Samaritan Hospital in Troy at 0.2 percent, St. Peter’s Hospital in Albany at 0.19 percent and Ellis Hospital in Schenectady at 0.16 percent.
St. Mary’s Hospital in Troy, Albany Memorial Hospital and Cobleskill Regional Hospital face no penalties.
The biggest penalty increases from 2018 to 2019 will be felt by Columbia Memorial and Saratoga Hospital, which will each see an additional 0.43 percent withheld.
Albany Medical Center, St. Mary’s in Troy, Samaritan and Nathan Littauer will see a decrease in penalties — due either to improved readmission rates or a change in the way Medicare now treats hospitals with large numbers of low-income patients.
Unlike previous years, Medicare is now grouping hospitals into categories based on the share of their patients enrolled in Medicaid — the government health plan for the poor — and then comparing their readmission rates against other hospitals in the same category.
This is in response to longstanding complaints from hospitals in poor communities, which note that their patients are far more likely to be readmitted simply because they cannot afford medication or don’t have regular doctors to monitor their care after discharge.