Getting out of the hospital is usually a good thing, but if you are released too early, you could wind up coming back and getting readmitted. Medicare penalizes hospitals that release patients too soon, by cutting the amount of money it sends to reimburse the hospitals for caring for Medicare patients.
Cheyenne Regional Medical Center has been penalized for the sixth year in a row, but its numbers have improved over last year.
As part of the Affordable Care Act, or Obamacare, hospitals around the country are required to submit information to Medicare about patient releases. Medicare is interested in these specific conditions:
- Acute Myocardial Infarction (AMI)
- Chronic Obstructive Pulmonary Disease (COPD)
- Heart Failure (HF)
- Coronary Artery Bypass Graft (CABG) Surgery
- Elective Primary Total Hip Arthroplasty and/or Total Knee Arthroplasty (THA/TKA)
If a patient is readmitted to the hospital for the same conditions within 30 days, Medicare considers that too early a release, and cuts the amount of money it sends to the hospital. The funds reimburse the hospital for caring for Medicare patients. Less money coming from Medicare means more expenses coming out of the hospital’s bottom line.
Hospitals are evaluated every year. For 2020, eight Wyoming hospitals had their benefits cut, including Cheyenne Regional Medical Center. The others are Campbell County Memorial Hospital in Gillette, Evanston Regional Hospital in Evanston, Ivinson Memorial Hospital in Laramie, Memorial Hospital of Sweetwater County in Rock Springs, Sheridan Memorial Hospital in Sheridan, St. John’s Medical Center in Jackson, and Wyoming Medical Center in Casper.
The penalties ranged from a high of 3% at St. John’s Medical Center, to .15% at Memorial Hospital of Sweetwater County. Cheyenne Regional Medical Center’s penalty was .67. That’s down from 1.26% last year.
“Cheyenne Regional was pleased to reduce our penalty to below 1%, and this was a significant contributing factor in our five-star (of five possible) rating from the Centers for Medicare and Medicaid Services in January,” said Dr. Jeffrey Chapman, Chief Medical Officer at Cheyenne Regional Medical Center.
Chapman would like to see the numbers of early readmissions reduced further. “We continue to work with our inpatient hospitalists and case managers and with our outpatient primary care providers to keep patients from requiring readmission,” he added.