Jump to Navigation

Emergency Care Threatened By Readmission Reduction Program

Photo of Armand Leone

Emergency care leading to hospital readmission rates within 30 days of a prior discharge will be penalized by Medicare and Medicaid in the form of reduced payments. The costs associated such readmission penalties will likely run into the millions of dollars. Two thirds of U.S. hospitals (2,211hospitals) will be penalized starting in 2013. Two hundred seventy eight (278) facilities have already been told that they will receive the maximum penalty of a 1% reduction in payments, which means millions less in payment to penalized hospitals. For example in Tennessee, Vanderbilt University Medical Center expects to be penalized between $500,000 and $1,000,000 a year, and Saint Thomas Health Hospital expects to lose about $1.2 million dollars a year in payments. Because every dollar lost hurts hospital operations, there will be increased pressure on Emergency Room physicians to not readmit recently discharged patients who need care.

Although some readmissions are genuinely related to poor quality, such as infections, surgical complications, blood clots and surgical hardware failures, about 25% of readmissions are not related to poor care and should not be calculated as part of the penalty. Patients get sick after discharge - sometimes because of the nature of the underlying problem, and sometimes because of a second health problem that arises afterwards. Some surgeries are two stage procedures that require two operations within 14 to 21 days.Regardless of the reason, Medicare and Medicaid payments to hospitals will be reduced if patients are readmitted within 30 days of discharge.

Each year, millions of people go to hosptials for emergency care expecting that decisions to treat and release or to admit are determined by an objective medical assessment. The Readmission Reduction Act will put financial pressure ER physicians to discharge patients who otherwise should be admitted. Unfortunately, determining payment penalties on "all cause" admission rates is not realistic and will cause more patients to suffer Emergency Room malpractice injuries.

No Comments

Leave a comment
Comment Information

Bold labels are required.

Contact Information
disclaimer.

The use of the Internet or this form for communication with the firm or any individual member of the firm does not establish an attorney-client relationship. Confidential or time-sensitive information should not be sent through this form.

close

Privacy Policy

"The mission of Britcher Leone, LLC is to unite the professional disciplines of medicine and law to help the victims of physicians' malpractice and serious personal injury restore their future and the future of their families." RSS FindLaw Network
Verdicts & Settlements
  • $1,237,004 Verdict for Failure to Properly Treat
  • $42 Million Dollar Vaccine Injury Structured Settlement
  • $5.7 Million Obstetrical Malpractice Structured Settlement
  • $3.8 Million Present Value Pediatric Urological Surgery Settlement
  • $3.38 Million Gross Medical Malpractice Verdict
  • $1.65 Million Present Value Spinal Surgery Settlement
  • $5.2 Million Obstetrical Malpractice Structured Settlement
  • $40 Million Vaccine Structured Award
  • $19 Million Vaccine Structured Award
  • $2.5 Million Failure to Timely Diagnose Breast Cancer Verdict
  • $16 Million Obstetrical Malpractice Structured Settlement
  • $13.6 Million Obstetrical Malpractice Structured Settlement
  • $3.5 Million Resort Negligence Settlement
  • $60 Million Flu Vaccine Structured Settlement
  • $2 Million Wrongful Birth/Wrongful Life Settlement
  • $3.5 Million Present Value Wrongful Death Settlement
  • $1.59 Million Medical Malpractice Judgment
  • $800,000 Recovery Failure to Treat Eye Infection and Vision Loss
  • $1.35 Million Wrongful Death Settlement
  • $1.2 Million Failure to Provide Adequate Security Settlement
  • $850,000 Settlement for Brachial Plexus/Shoulder Dystocia Injury
  • $1 Million Podiatric Malpractice Judgment
  • $863,000 Orthopedic Malpractice Judgment
  • $850,000 Radiology Malpractice Settlement
  • $800,000 Cardiology Malpractice/Wrongful Death Settlement
View All Verdicts
Google+ LinkedIn Uniting Medicine & Law | Rebuilding Your Future