Hospital Readmission Rule Essay

A hospital’s primary goal should be to provide quality medical care to the patients so that they can be as healthy as possible. A possible way to be able to measure the quality of care a hospital is giving would be to look at their readmission numbers. If a patient is readmitted into a hospital in a short period of time after being discharged, then it is very likely that the hospital did not fully address the patients’ health needs during the initial stay. In an effort to improve the quality of service that hospitals are giving, the Medicare 30-day readmission rule was established to help by incentivizing hospitals to provide better quality care for its patients or be financially penalized.

The Affordable Care Act (ACA) was signed into law

As mentioned previously, the Hospital Readmissions Reduction Program was introduced to improve quality for patients and reduce costs. The Hospital Readmission Reduction Program helps improve quality by giving hospitals an incentive to have less Medicare patient readmissions within 30 days by penalizing the hospital if they have too many readmissions. By having this potential financial penalty, hospitals will want to provide their patients with the best quality treatment so that the patient is not readmitted within 30 days. While the Medicare 30-day readmission rule helps the quality of care that Medicare patients receive, it also has large financial impacts on hospitals. Whenever a hospital has higher readmission rates than the ERR set, the Hospital Readmissions Reduction Program penalizes the hospital by reducing the Medicare payments (Gai & Pachamanova, 2019). When the Medicare payments to a hospital are reduced, this can lead to a decrease in revenue because Medicare is a large source of funding for many hospitals. Another way hospitals may be financially impacted by the Hospital Readmissions Reduction Program would be that they may need to spend more money on staff, training, and equipment to ensure they are giving the best quality of care possible to avoid readmissions. Because of the potential reduction of Medicare funds, managers in hospitals are affected because they now will have more responsibilities associated with budgeting and quality assurance. As a manager at a hospital that is being penalized by the Medicare 30-day readmission rule, the manager will have to figure out solutions for improving quality. Some things a manager may do in this situation may be getting additional training for their employees as well as monitoring their performance to make sure they are giving the patients the best quality of care