Those low performing hospitals hit hardest will be those serving the poorest.
The National Association of Public Hospitals and Health Systems immediately blasted the Medicare DSH proposal. “The DSH methodology has long been criticized for failing to account for the costs of providing care to uninsured individuals,” said Beth Feldpush, senior vice president for policy and advocacy at NAPH, in a prepared statement. “Rather than taking into account the cost of providing care to the uninsured, CMS has instead continued to rely on the same unsound proxy that ignores uninsured individuals and instead focuses on Medicaid and low-income Medicare patients.”
The proposal also slaps new penalties on hospitals that fail to participate in the Hospital Inpatient Quality Reporting (IQR) program, which is fewer than 1% of all hospitals. They would receive a 2 percentage point reduction in the proposed increase. The hospital IQR program now evaluates 57 quality measures, including heart attack, heart failure and pneumonia, related to healthcare-associated infections, surgery and patient experience, in assessing hospitals' ability to improve quality.
The changes in the quality incentive programs were mandated by Affordable Care Act. The Hospital-Acquired Condition reduction program that starts in 2015 will penalize hospitals that rank among the lowest-performing quartile of hospitals in curbing hospital-acquired conditions by 1% of their total payments. It also proposed adding the two measures—hip and knee arthroplasty and COPD—to the conditions used in calculating readmission penalties, which can be as high as 2% of Medicare reimbursement.
And those hospitals that can pick their patients; prosper. One of those unintended consequences of ACA… I suppose, who knows with Obama’s Clout habits.