Analysis: 29 Kansas hospitals to face financial penalties for readmission rates; Lawrence Memorial isn't among them

Lawrence Memorial Hospital, 325 Maine.

Lawrence Memorial Hospital, 325 Maine.

Twenty-nine Kansas hospitals will be penalized by the government starting in October because their Medicare patients were readmitted too soon after discharge, according to a recent analysis by Kaiser Health News.

Lawrence Memorial Hospital is not one of them.

“I think we have taken a proactive and a collaborative approach,” LMH President and CEO Gene Meyer said of reducing its readmission rates.

He said doctors, nurses and social workers work together and then coordinate with area agencies to ensure the patient is taken care of once he or she returns home.

LMH receives about $60 million annually in Medicare reimbursements, and it likely won’t lose any of it because of the new penalties that are being implemented as part of the Affordable Care Act’s Hospital Readmissions Reduction Program.

Nearly one in five Medicare patients, or 2 million beneficiaries, are readmitted within 30 days of release each year, costing Medicare $17 billion in additional hospital bills, according to Kaiser Health News. The national average readmission rate has remained steady at slightly above 19 percent for several years, and that’s because hospitals have had little financial incentive to ensure patients received the care they needed once they left. That is until the Affordable Care Act, also known as health reform or Obamacare, was passed.

Beginning Oct. 1, hospitals can lose up to 1 percent of their base Medicare reimbursements. The penalties will be deducted from reimbursements each time a hospital submits a claim. For example, if a hospital received the maximum penalty of 1 percent and it submitted a claim for $20,000 for a stay, Medicare would reimburse it $19,800. The maximum penalty will increase to 2 percent in October 2013, and then it will increase to 3 percent the following year.

The penalties are based on the frequency that Medicare heart failure, heart attack and pneumonia patients were readmitted within 30 days between July 2008 and July 2011.

Kaiser analyzed hospital readmission records nationwide and released its findings last week. It found:

• 2,211 — hospitals nationwide will be penalized a total of $280 million in Medicare funds.

• 278 — hospitals will lose the maximum amount.

• 29 — Kansas hospitals will be penalized.

• 2 — Kansas hospitals will lose the maximum amount. They are Coffey County Hospital and Morton County Hospital.

Kansas University Hospital's main entrance in Kansas City, Kan.

Kansas University Hospital's main entrance in Kansas City, Kan. by Kevin Anderson

Kaiser Health News estimated that Kansas University Hospital would face a penalty of .38 percent for its readmission rate.

Dr. Lee Norman, KU Hospital senior vice president and chief medical officer, said the estimate was in line with the hospital’s estimates, which means they would lose about $360,000 a year. KU Hospital receives about $75 million annually in Medicare reimbursements.

Norman said KU Hospital has worked to reduce readmission rates in a number of ways. Among them is a new “huddle concept” where the doctors, nurses, pharmacists, therapists and case managers meet briefly once a day to discuss each patient.

“This huddle concept is incredibly powerful for getting everybody on the same page with the family and with the patients,” he said.

Norman said they also try to identify early on the patients who are higher risk of readmission. Often, these are patients who have multiple conditions or lack support at home.

Norman, who has been a doctor for more than 30 years, said medicine is one of the leading causes of readmissions. He said patients either don’t understand their medications or they just don’t have the money to buy them.

“Patients are proud. They don’t want to tell their nurses and doctors that they don’t have the money to pay for the medication when they get home,” he said.

So, KU Hospital staff focus on educating the patients before they leave and often follow up once they are home.

“I personally think that paying for performance and paying for quality is the way to go,” Norman said. He pointed out that the readmission rate is just one measure, but there are other measures where KU is getting paid more because they are meeting or exceeding standards. “We have been very successful through the years of getting to the top of performance measures in terms of quality.”

KU is among the top 20 percent of academic hospitals nationally when it comes to taking care of patients with complicated cases.

“That’s an elite, select kind of patient that unfortunately is more likely to be readmitted,” Norman said. “I just hope it doesn’t penalize us to a point where we worry about our mission. To this point, we are not anywhere close to that.”

— Kaiser Health News contributed information to this story.


READMISSION PENALTIES

Kaiser Health News recently released its analysis of the penalties hospitals could be facing because too many Medicare patients were readmitted within 30 days of discharge. The maximum penalty amount is 1 percent of their base Medicare reimbursements. Here’s how hospitals fared in the Lawrence region:

• Providence Medical Center, Kansas City, Kan. — 0.79 percent.

• St. Luke’s Hospital of Kansas City, Mo. — 0.52 percent.

• Shawnee Mission Medical Center — 0.45 percent.

• Kansas University Hospital — 0.38 percent.

• Menorah Medical Center, Overland Park — 0.37 percent.

• Saint John Hospital, Leavenworth — 0.33 percent.

• St. Luke’s Hospital South, Overland Park — 0.31 percent.

• Overland Park Regional Medical Center — 0.15 percent.

• Ransom Memorial Hospital, Ottawa — 0.13 percent.

• Cushing Memorial Hospital, Leavenworth — 0.02 percent.

The following would receive no penalties: Lawrence Memorial Hospital, Olathe Medical Center, St. Francis Health Center of Topeka, and Stormont-Vail Healthcare of Topeka.

For a complete list, visit kaiserhealthnews.org.

Tagged: Kaiser Health News, Kansas University Hospital, Lawrence Memorial Hospital

Comments

Lawrence Morgan 1 year, 11 months ago

It seems to me that people with heart conditions, for example, may need to be readmitted to care for additional worries and concerns. There are sometimes complications that don't become serious until after the first admission. That's neither the patient's nor the doctor's nor the hospital's fault.

And as for the money to take care of medications, that should be worked out satisfactorily before the patient leaves. Being in the hospital is no time to be proud. It's time to be taken care of.

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GardenMomma 1 year, 11 months ago

How does this hurt the Medicare patient? Hospitals are now motivated to provide better after-care to keep patients from coming back to the hospital. It's not costing the patient anything, in fact, it's giving them something better.

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LeBo 1 year, 11 months ago

The freeloaders are already getting treated at the emergency room for chronic aliments that should be handled by a doctor's clinic. Yes, this is a problem area. But, think about the people that work 80 hours per week at three part-time jobs with no healthcare. Plus, I am a veteran.

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nativeson 1 year, 11 months ago

This is a tough issue. This Affordable Care Act provision is like throwing sand in the ocean. The number of Medicare patients will double in the next 25 years. The reimbursement rates to the provider hospital will on average be much lower than private insurance.

This change has nothing to do with legislation. Our health care system will be radically impacted by an aging population regardless of who is in Washington.

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Centerville 1 year, 11 months ago

Welcome to Medicare (ahem) as we are about to "know it", suckers.

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Enlightenment 1 year, 11 months ago

This is a win win situation, bigger win for the patient. The hospitals are going to provide better care to patients and they will likely have longer more fulfilling lives because of it. The hospitals will also have a better rating and more credibility as a result, making them more profitable. On top of it all, it saves Medicare lots of money. Just one more positive attribute of the ACA.

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asixbury 1 year, 11 months ago

You obviously don't know what you're talking about. Obamacare had the patient's needs in mind, instead of the hospitals. This measure motivates the hospitals to do a better job at taking care of patients the first time around. This will lead to less governmental waste of yours and my tax dollars when the readmission rates go down. This is good for the patients; not bad. Just because it came from Obama's Presidency does not mean it is bad....you are unable to separate your opinion on the President from the actual measure.

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Paul Wilson 1 year, 11 months ago

You just keep telling yourself that and it will come true. This will only lead to increased costs. Name one Government program that runs in the black. There is not one. They run in the red no matter what party is in control of each applicable branch. And yes...if it comes from Obama...history has shown us...it is probably bad and very misguided. Read up on socialism and communism a bit. Then compare and contrast them to Obama's policies. You should get very worried...unless you want something you didn't earn like a majority of Libs in this country. Liberals complain about everything the Government does...yet they trust them to run a National Health Care system. Unbelievable.

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kulawl 1 year, 11 months ago

Based on personal experience a large part of the problem results from patient behavior. It is almost shocking to see the number of patients who completely ignore discharge instructions or simply refuse to take medication upon leaving the hospital.

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headdoctor 1 year, 11 months ago

SageonPage

ObamaCare is a shameful disgrace to our health care providers. Stop it now, vote against Socialism in November.


Who is this non-Socialist presidential candidate that you are hinting at so others may vote against Socialism? I was under the impression that Obama and Romney were the only serious choices. As far as those that you believe are lib posters. They are all out working a real job so they don't have time to be online all the time. You know. The ones who have to pick up the slack to cover for your meager self employment.

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headdoctor 1 year, 11 months ago

Anyway Sage, most people who have had any exposure to our health care system knows it has problems. Like many other issues, those who could fix it have no desire to do so because there is no incentive for them to do it. There are many factors that will soon be in conflict such as hospitals remaining solvent, accreditation, malpractice, Hippocratic Oath, etc.

At least Obama is trying to do something. All the Republicans want to do is stick one thumb in their mouth and the other in their rear and wait for someone to yell switch. That way they look busy but aren't accomplishing anything.

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headdoctor 1 year, 11 months ago

And 15 bureaucrats making decisions is different from and insurance rep refusing to approve payment for treatment how?

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headdoctor 1 year, 11 months ago

If the Republicans have so many good ideas why haven't they ever put any of them to work. National healthcare isn't a new subject. I would have thought that after more than 3 decades they could have actually done something on their own. Oh, that is right, they did. Created their own power grab of everything else but healthcare with the only choice left to pick from was for their own benefit.

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headdoctor 1 year, 11 months ago

I keep hearing about a free market. Exactly where is this free market that you speak of? Not here in the US and not in to many other places either.

Anyway, I knew you and other posters like you are not interested in a serious debate. Deflecting and moving the subject around may be debate tactics but the reality is you are not interested in anything that resembles the truth or a real debate. All you want to do is run your mouth to see what you can stir up. You must have very little self worth if mouthing and trolling on a forum gets you to your happy place. It sure isn't converting anyone to the Republican side.

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headdoctor 1 year, 11 months ago

Considering you don't even understand that this article has nothing to do with Obama care since it hasn't even started yet I doubt you could explain anything.

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rodentgirl16 1 year, 11 months ago

Kinda sounds like Sage couldn't afford his or her meds.

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