Lisa Bernard-Kuhn reports:
Four Southwest Ohio hospitals have re-admission rates higher than their national peers, new federal data shows. The finding comes as the government continues to push hospitals to improve – by paying them for the quality of their treatment in some situations rather than the number of patients they treat.
University of Cincinnati Medical Center, West Chester Hospital, Mercy Hospital Fairfield and Mercy Hospital Anderson made the list for having higher rates of Medicare patients who returned within a month for unplanned reasons. They were among about 8 percent of hospitals nationwide with poorer than average results, according to new data released Monday.
Overall readmission rates are significant because the Medicare Payment Advisory Commission, which advises Congress, has encouraged lawmakers to use this measure when determining financial penalties for hospitals under a key provision in the Patient Protection and Affordable Care Act. One of the 16 commission members is Willis Gradison, a former Republican congressman from Cincinnati.
Some of the facilities on the list of higher than average re-admission rates are among the most revered in the country, such as the Cleveland Clinic and Duke University Hospital in Durham, N.C.
Other major Ohio hospitals on the list included Ohio State University Hospitals in Columbus and University Hospitals in Cleveland. Major Kentucky hospitals on the list included University of Kentucky Hospital in Lexington and University of Louisville Hospital in Louisville.
Seven percent of American hospitals had lower rates of re-admission than their national peers. But no hospitals in Southwest Ohio, Northern Kentucky or Southeast Indiana made this list, which means that the performance of all the other local hospitals was average.
Officials from UC Health and Mercy could not immediately be reached for comment.
Medicare is currently fining 2,225 hospitals – including 14 locally – for excess re-admissions for three common ailments under Obamacare.
The penalty program began in October 2012. During the first eight months of 2013, fewer than 18 percent of Medicare patients ended up back in the hospital within a month of discharge, the lowest rate in years, the government reported last month. Officials seized on the decrease as evidence the incentives are having an effect.
In the current fiscal year that started Oct. 1, Medicare is levying a total of $227 million in fines against hospitals in every state but Maryland. Locally, Mercy Health’s Jewish Hospital in Sycamore Township faces the toughest fine: 1.15 percent of every payment for a Medicare patient stay.
But the number of cases of heart attack, heart failure and pneumonia for many hospitals is quite small, making it hard for the government to make accurate assessments of their readmission rates.
In December, the government expanded its disclosure by publishing hospital rates of Medicare patients no matter why type of ailment they had who returned to a hospital within a month for unplanned reasons.
The data released Monday showed that 17 Ohio hospitals – or about 1 of every 10 in the state – had re-admission rates higher than their national peers, an Enquirer analysis showed. That’s better than hospitals in Kentucky, Illinois, Maryland, Massachusetts, New Jersey, New York or Rhode Island. At least 20 percent of the hospitals in those seven states had higher rates of re-admissions than the national average, analyses by the Enquirer and Kaiser Health News showed.
Colorado, Hawaii, Idaho, North Carolina, Oregon, South Carolina, Utah and Washington led the states with the highest proportion of hospitals with low readmission rates. In those states, between 13 and 16 percent of hospitals came in below the national average, the Kaiser analysis showed. In Indiana, 11.5 percent of hospitals came in below the national rate, compared to only 3 percent that had high re-admission rates, the Enquirer analysis showed.
The hospital industry and some independent researchers have expressed reservations about the re-admissions measures, Kaiser said in a report Monday. They say they do not reflect that some hospitals end up saving lives by being more aggressive in readmitting patients at early signs of trouble. They also complain that hospitals with large proportions of low-income patients often have higher readmission rates because those patients often don’t have the money for follow-up care and are more likely to lack their own primary care physician.
Finally, while Medicare does take the degree of patient sickness into account when judging hospitals, academic medical centers say that the government analysis isn’t refined enough to fully notice which patients are sicker than others with the same ailment.
You can read the full national story, including a list of all hospitals nationally that performed better or worse than the national average on re-admissions, by Kaiser’s Jordan Rau here.