Medicare under the Hospital Readmissions Reduction Program (HRRP) will reduce reimbursement for 2,573 hospitals for fiscal year (FY) 2018, accordingCMSdatareleased Wednesday, Jordan Rau reports forKaiser Health News.
The latest penalties are based on readmissions between July 2013 and June 2016. The penalties will apply to Medicare payments that CMS makes to the affected hospitals between Oct. 1, 2017 and Sept. 30, 2018.
Under HRRP, CMS withholds up to 3 percent of regular reimbursements for hospitals if they have a higher-than-expected number of readmissions within 30 days of discharge for six conditions:
Chronic lung disease;
Coronary artery bypass graft surgery;
Hip and knee replacements; and
According toKaiser Health News, more than 1,500 hospitals were exempt from the program this year, including veterans' hospitals, children's hospitals, critical access hospitals, and psychiatric hospitals. Hospitals in Maryland also were exempt because the state has a federal waiver related to how it distributes Medicare funding.
Penalties for FY 2018
According to aKaiser Health Newsanalysis of the data, about 80 percent of the 3,241 hospitals CMS evaluated this year will face penalties. The number of penalized hospitals in FY 2018—2,573—marks a slight decline from FY 2017, when Medicare reduced reimbursements for 2,597 hospitals.
According toKHN, all but 174 of the hospitals that were docked for FY 2018 faced penalties in FY 2017 as well.
TheKHNanalysis of the data also showed CMS under HRRP will withhold $564 million in payments over the next year—up slightly from the $528 million withheld for FY 2017.
According toKHN, the average penalty in FY 2018 held steady at 0.73 percent. Forty-eight hospitals in FY 2018 will receive the maximum 3 percent penalty.