©2010 Health Dimensions Group
©2010 Health Dimensions Group
©2010 Health Dimensions Group
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Avoidable Hospital Readmission<br />
Penalties<br />
• Medicare payments reduced for avoidable admissions for three<br />
conditions as of October 1, 2012:<br />
– Likely the conditions for which hospitals now report readmissions:<br />
• Congestive heart failure (CHF)<br />
• Heart attack (AMI)<br />
• Pneumonia<br />
– In FY 2015, the number of conditions may be increased<br />
• Payment formula: payments for avoidable readmissions,<br />
aggregate Medicare payments to a hospital:<br />
– Subject to a “floor”—payment reductions will be no greater than<br />
percentage of aggregate Medicare payments to hospitals:<br />
• FY2013 1%<br />
• FY2014 2%<br />
©2010 <strong>Health</strong> <strong>Dimensions</strong> <strong>Group</strong><br />
• FY2015 and beyond 3%<br />
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