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AHA Rejects Proposed Readmission Penalties

Cheryl Clark, for HealthLeaders Media, June 25, 2012

Coding
The AHA also says it has serious concerns over the proposed rule's plan to cut 1.9% and another .8% that in essence attempt to correct for case-mix coding problems between 2007 and 2010.

But the AHA says "there is a fundamental flaw in CMS's methodology for determining the effect of documentation and coding...The AHA is extremely troubled by this proposal and by the fact that CMS continues to compare hospitals' documentation and coding practices to their documentation and coding practices under an entirely different system in FY 2007."

The final rule is expected to be released in August.


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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1 comments on "AHA Rejects Proposed Readmission Penalties"


Tom Johnson (6/25/2012 at 8:30 PM)
Rick Pollack is right on target with his criticisms of this CMS readmission penalty rule. Study after study have pointed out that patients in the lower socio-economic rung tend to have more co-mobidities; they tend to have less access to health care information; they often don't have access to primary care services; they don't have the same level of compliance to accepted health care guidelines for self care, etc. Their re-admission rate is bound to be higher and many of these patients are under Medicaid or are uninsured so hospitals taking care of a disproportionate share of these patients will be unfairly penalized. This CMS rule is a utopian rule not grounded in reality. Tom Johnson, LFACHE