Home From The Editor Is health care reform about to arrive in your hospital?

Is health care reform about to arrive in your hospital?

April 2009

Published in the April 2009 issue of Today’s Hospitalist

IS THE INCREASINGLY HEATED RHETORIC about health care reform about to come home to roost for hospitals “and by extension, hospitalists?

Throughout the presidential campaign, health care was a hot topic. Now, with the country bogged in an economic crisis, the Obama administration is pressing health care reform as a key to our financial recovery.

In its proposed changes to health care financing, the Obama administration has listed a series of initiatives to rein in costs, from reducing Medicare overpayments to slashing drug prices. But one initiative should get the attention of hospitalists: a proposal to stop paying for unnecessary rehospitalizations.

One White House budget document predicts that a plan to reduce unnecessary readmissions could save up to $26 billion over 10 years. That’s because, according to White House figures, nearly 18% of hospitalizations of Medicare beneficiaries result in a readmission within 30 days of discharge, some of which are unnecessary.

The solution? Medicare would bundle payments that cover not only the hospitalization, but care from certain other post-acute providers within the next 30 days. Hospitals with high readmissions rates would be paid less if patients are readmitted to the hospital within that 30-day period.

Exactly what this means for hospitals is unclear. Medicare rules already prohibit hospitals from being paid for many readmissions within 30 days, but this new proposal would seem to up that ante.

One thing seems clear: If hospitals are going to see more financial penalties for unnecessary readmissions, hospitalists are among the first physicians they’ll approach for help. Are you ready?

edoyleEdward Doyle
Editor and Publisher