Reflex: September 29, 2011

U.S. hospitals, facing new Medicare penalties, show wide room for improvement at reducing readmission rates, reports the Robert Wood Johnson Foundation. “The readmission rate to a hospital is increasingly seen as a marker of a local health care system’s ability to coordinate care for patients across care settings, and readmissions are often a sign of inadequate discharge planning and the lack of effective community-based care. Centers for Medicare & Medicaid Services (CMS) has estimated the cost of avoidable readmissions at more than $17 billion a year. In hopes of decreasing these costs, Medicare plans to reduce payments for readmissions, exposing hospitals to considerable financial risks. In fiscal year 2013, hospitals face a penalty equal to 1 percent of their total Medicare billings if an excessive number of patients are readmitted. The penalty rises to 2 percent in 2014 and 3 percent in 2015.” Aaron’s Comment: I’ve complained before that health care reform has a lot of carrots and too few sticks. This is definitely a stick. We’ll have to see how it plays out.

Yesterday, the US Government picked the case it wants to appeal to the Supreme Court: the 11th Circuit (Florida) health reform case (brief here), but not the 6th Circuit (Thomas More Law Center) case (brief here), unless the court wants to take them both up together:  “In the federal government’s view, the Court should grant the federal government’s petition in Florida and hold this petition pending a decision in Florida.  Like this case, Florida presents a court of appeals decision analyzing the constitutionality of the minimum coverage provision under both the tax and commerce power, so it provides a vehicle for the Court to address both questions if necessary.” Kevin’s Comment:  The Obama Administration is running to the sounds of battle, refusing to delay the cases with petitions for rehearing en banc* and choosing to appeal the one Court of Appeals case they lost.

      * Rehearing in front of the entire 11th Circuit instead of a 3-judge panel.

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