Readmissions are a key measure of a hospital???s quality because they may show that a hospital is not providing appropriate care the first time, triggering the patient to return to the hospital within a short time after discharge. The patient may develop an infection, or suffer from a surgery performed incorrectly.
There are financial incentives built into the Affordable Care Act (ACA) that will push hospitals to improve quality by reducing readmissions or potentially lose Medicare funding. For example, hospitals that fall in the bottom quarter for certain heart- and pneumonia-related readmissions of patients insured by Medicare will have reimbursements reduced. Penalties begin in 2013, so hospitals have been aggressively working to reduce the potential for readmissions.
The ACA will develop a new payment system for Medicare to pay hospitals on their performance rather than simply giving them reimbursement for whatever procedures are done, whether they are done poorly or well. The new system will also be applied to skilled nursing facilities, surgical centers where people receive treatment on an outpatient basis, and home health agencies.
How Does the Affordable Care Act (ACA) Aim to Work With Individual Patients After They Leave the Hospital to Reduce Hospital Readmissions?
What Are the Various Ways to Measure and Compare Health Care Quality?
What Does the Affordable Care Act (ACA) do to Improve Medical Effectiveness?