Medicare, CMS, Hospitals, and Unnecessarily Institutionalization. Information Bulletin # 334 (6/2011).
There’s been a number of news articles recently stating that CMS will track hospital spending for Medicare recipients and will reward hospitals that keep costs down and penalize hospitals for costs incurred within 90 days after the person leaves the hospital.
It’s a “Medicare spending per beneficiary” device to measure hospital performance. For example, we have national data for infections occurring after surgery and/or as a result of just being in a hospital. Hospitals with much higher rates will be penalized. Similarly, there’s national data for heart attack mortality rates against which hospitals can be compared, rated, and then rewarded or penalized.
Obviously, besides improving medical care, rewards/penalties are an important strategy to control health costs, something everyone agrees is necessary.
We have a simple suggestion for CMS.
How about CMS including in its “Medicare spending per beneficiary” the measure of placement in nursing homes directly from acute care hospitals? This could actually be easily implemented because CMS could actually enforce its own federal regulations which require hospitals to do real and meaningful “discharge planning”?...
CMS - you have a financial interest, the regulatory authority, as well as an interest in the ADA’s mandate that services be provided “in the most integrated setting appropriate,” to address hospital dumping.
Include in the “Medicare spending per beneficiary” plan a measure of post-hospital placements. Reward hospitals that place people in the community with services and penalize hospitals with the worst dumping scores.
What other steps can be taken to address hospital dumping? Please share your thoughts in comments below.