30-Day Readmissions Rule Under Two-Pronged Attack

"If a penalty is more than offset by program costs and lost rehospitalization revenue, hospitals would be better off financially if they maintained the status quo," they wrote.

The authors propose a Medicare pricing system such as Geisinger Health's ProvenCare, which creates a single episode price for all care associated with surgery for 90 days, including any rehospitalizations, "in essence, a warranty."

This would remove entirely "the perverse incentives associated with payments for avoidable readmissions," and Medicare would be guaranteed savings.

They concluded that "increasing penalties for readmissions, but not all admissions, provides a clearer incentive for hospitals to pursue readmissions-reduction programs and enhance quality and efficiency while more fundamental payment reform is being explored."

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