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New Medicare Penalties Might Force Post-Surgery Care Improvements

Despite the generally good quality of Florida healthcare, a large number of patients have to go back to hospitals for emergency care after an operation. New federal penalties seek to reduce these rates by cutting Medicare reimbursements to hospitals with high rates of post-care readmission.

According to several recent studies published in the Journal of the American Medical Association, around one in five patients in the United States requires unexpected follow-up care. Even worse, 40 percent of those patients return to emergency room facilities. This could point to cases of medical malpractice or hospital negligence. Routine follow-up treatment is one thing – but this high rate of emergencies suggests that something went wrong for these patients.

The Wall Street Journal quoted Harlan Krumholz, a co-author of one of the studies, as saying “The month after a hospital discharge is a period of great susceptibility and vulnerability where people need to regain their balance and recover from all the blows, and we need to change the way we work together as a health community to provide better support and a soft landing for these patients.”

As this quote indicates, experts believe that this high rate reflects systemic failures on the part of the medical profession. Two possible causes could be that hospitals are not doing enough to spot complication-susceptible patients or that the system is not successfully helping patients transition from in-patient care.

For hospitals with higher-than-expected rates of readmission, penalties are on the horizon. Medicare reimbursements are an important source of hospital revenue and the program plans to penalize outlying hospitals by cutting up to one percent of their reimbursement amounts. Hopefully the existence of these penalties will encourage hospitals to take meaningful action on behalf of vulnerable patients.

Source: Wall Street Journal, “Return Patients Vex Hospitals,” Laura Landro, Jan. 22, 2013

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