News: 774 hospitals penalized for avoidable complications, Medicare payments cut

CDI Strategies - Volume 15, Issue 8

Between mid-2017 and pre-pandemic 2019, 774 hospitals have been penalized by the federal government for having high rates of patients with possibly avoidable medical complications, according to a hospital penalty “look-up” system by Kaiser Health News. The penalized hospitals will lose 1% of their Medicare payments over the fiscal year due to the penalty.

Under the Affordable Care Act, the government cuts payments to hospitals that have high readmission rates, as well as those with the highest number of infections and patient injuries, accounting for the possibly avoidable medical complications noted above. For the patient safety penalties, Medicare cuts payments up to 1%, while for readmission penalties Medicare cuts as much as 3%.

Under the Hospital-Acquired Condition Reduction Program, each year Medicare must punish the 25% of general care hospitals who have the highest rate of patient safety issues. The total penalty amount is based on Medicare payments received by each hospital during the previous fiscal year.

Editor’s note: The Kaiser penalty look-up tool can be found here. To read more about quality-of-care penalties, click here.

Found in Categories: 
Denials & Appeals, News