Readmission penalties have been regarded as harsh, disputable, but still necessary measures to facilitate the progress of the American healthcare system. In 2020, 2,545 healthcare facilities under Hospital Readmissions Reduction Program (HRRP) had to pay readmission penalties, which was over 83% of all hospitals taking part in the program (“Map: See the 2,545 hospitals that face readmission penalties,” 2020). The average amount of penalty was approximately 0.69% (while it was 0.71% in 2019). This amount may seem rather small for some, but hospitals have tight budgets, and any financial losses have a considerable influence on their functioning. At that, penalties are an indispensable part of quality improvement measures.
From the insurer’s perspective, these penalties have a negative impact as they increase costs. Clearly, readmissions lead to increased costs that can often be prevented, but in many cases, hospitals can hardly be accountable for people’s health conditions after their discharge. This is especially true during the COVID-19 pandemic when people are exposed to increased risks of being infected and developing complications. The load on hospitals is also growing, which should also be taken into account when considering the measure to improve health care quality. The penalties can become a considerable burden for hospitals in the future due to the pandemic-associated factors and further tightening budgets.
Clearly, quality improvement is one of the highest priorities to pursue, but readmission penalty policies should undergo certain changes to meet the needs of the current situation. It can be beneficial to reconsider the protocols and evaluations of the facilities that must be punished. It is critical to make sure that the reason for readmissions was hospital-related as, in the opposite case, healthcare facilities may feel demotivated to participate in the HRRP.
Reference
Map: See the 2,545 hospitals that face readmission penalties this year. (2020). Advisory Board. Web.