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MA Hospitals Cry Foul Over State Readmission Fines

Cheryl Clark, for HealthLeaders Media, September 26, 2011

Gens says that MHA members also object because the names of the hospitals with allegedly higher readmission rates were released without allowing "time for them to look at this data and see if it is correct. Some hospitals have already said that it is not correct."

David Smith, MHA's senior director for health data analysis and research, said in a telephone interview on Friday that MHA objects to this method because it "eliminates the possibility that bad luck or random chance could have put the institution above average in readmissions."

On the Centers for Medicare & Medicaid Services website, HospitalCompare, hospitals with higher rates of readmission are identified as having higher or lower rates of readmission, but only 292 hospitals are put in the "worse than national average" category out of more than 4,500 facilities. Many facilities with higher rates of readmission than average are not included unless their rates are at the extreme end.

With the Massachusetts formula, about 33% of the hospitals, rather than 6% of Medicare hospitals, is tapped for a penalty.

"Anyone who is above average is deemed to have excess readmissions," Smith said. "For example, they might say that based on your case mix, you would have 150 readmissions. Well, if you had 151, then you get the penalty."

Smith added that another objection is that "it essentially treats admissions as if the hospital is entirely responsible for them. That's clearly not the case. There are many things that can happen following the discharge that have nothing to do with the care the patient received.

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