Stay ahead of developments in federal and state health care law, regulation and transactions with timely, expert news and analysis.
March 11 — Three provider trade associations are supporting legislation that would allow the CMS to account for patients' sociodemographic status when considering penalties for hospitals with excessive readmissions.
In separate press releases dated March 10, the American Hospital Association (AHA) and the Association of American Medical Colleges (AAMC) said they support the legislation, the Establishing Beneficiary Equity in the Hospital Readmissions Program Act of 2015 (H.R. 1343/S. 688). Reps. James Renacci (R-Ohio) and Eliot Engel (D-N.Y.) March 10 introduced the bill in the House. Sens. Rob Portman (R-Ohio) and Joe Manchin III (D-W.Va.) March 10 introduced the bill in the Senate.
In addition, America's Essential Hospitals (AEH) said, “This legislation will ensure fairness in the readmissions reduction program and allow high-performing essential hospitals to maintain the resources they need to reduce readmissions and care disparities.” The AEH statement originally appeared in a March 10 press release on Portman's website.
The bill “will improve the fairness” of the Centers for Medicare & Medicaid Services' readmissions program, the AHA said. Currently, the group said, the readmissions program doesn't recognize “sociodemographic factors” outside a hospital's control that affect a patient's health, such as a patient's ability to pay for necessary follow-up treatments and easy access to appropriate food, and their likelihood of being readmitted. “The legislation will greatly improve the fairness of readmission penalties by taking into account both the proportion of the hospital's patients eligible for both Medicare and Medicaid and the patients' sociodemographic status,” the AHA said.
Sens. Roger Wicker (R-Miss.), Mark Kirk (R-Ill.), Bill Nelson (D-Fla.) and Sherrod Brown (D-Ohio) are co-sponsors of the legislation in the Senate, a March 10 statement from Manchin said.
If passed, the bill “will help to ensure that hospitals treating our nation’s most medically complex and vulnerable patients are not unfairly and disproportionately penalized by the Medicare Hospital Readmissions Reduction Program (HRRP),” the AAMC statement said.
The HRRP requires the CMS to penalize hospitals that have excess readmissions compared with expectations, the AAMC said. “However, the causes of readmissions are complex, and strong evidence clearly links low socioeconomic status to higher rates of readmission,” the group added.
The AAMC also said the agency doesn't currently consider socioeconomic status when determining the expected number of readmissions. “This legislation requiring CMS to account for socioeconomic status will measure quality of care more accurately and is an essential improvement to the HRRP,” the group said.
The legislation is budget-neutral, Portman's statement said.
Specifically, the bill would alter the HRRP as governed by the Affordable Care Act, Manchin's statement said.
Under the legislation, the CMS would have to account for patient socioeconomic status when calculating the risk-adjusted readmissions penalties, Portman said.
Failing to recognize patient socioeconomic status “has led to unfair penalties at many rural hospitals in West Virginia and around the country,” Manchin's statement said.
Likewise, a March 10 statement from Renacci said, “As a former businessman with a long record of experience in the health care industry, it’s clear that the HRRP unfairly penalizes safety-net and teaching hospitals—taking valuable resources from those who are in need of them most.”
To contact the reporter on this story: Michael D. Williamson in Washington at firstname.lastname@example.org
To contact the editor responsible for this story: Brian Broderick at email@example.com
The House bill is at https://www.congress.gov/bill/114th-congress/house-bill/1343.
The Senate bill is at https://www.congress.gov/bill/114th-congress/senate-bill/688.
All Bloomberg BNA treatises are available on standing order, which ensures you will always receive the most current edition of the book or supplement of the title you have ordered from Bloomberg BNA’s book division. As soon as a new supplement or edition is published (usually annually) for a title you’ve previously purchased and requested to be placed on standing order, we’ll ship it to you to review for 30 days without any obligation. During this period, you can either (a) honor the invoice and receive a 5% discount (in addition to any other discounts you may qualify for) off the then-current price of the update, plus shipping and handling or (b) return the book(s), in which case, your invoice will be cancelled upon receipt of the book(s). Call us for a prepaid UPS label for your return. It’s as simple and easy as that. Most importantly, standing orders mean you will never have to worry about the timeliness of the information you’re relying on. And, you may discontinue standing orders at any time by contacting us at 1.800.960.1220 or by sending an email to firstname.lastname@example.org.
Put me on standing order at a 5% discount off list price of all future updates, in addition to any other discounts I may quality for. (Returnable within 30 days.)
Notify me when updates are available (No standing order will be created).
This Bloomberg BNA report is available on standing order, which ensures you will all receive the latest edition. This report is updated annually and we will send you the latest edition once it has been published. By signing up for standing order you will never have to worry about the timeliness of the information you need. And, you may discontinue standing orders at any time by contacting us at 1.800.372.1033, option 5, or by sending us an email to email@example.com.
Put me on standing order
Notify me when new releases are available (no standing order will be created)