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Readmissions: The Death Penalty

Written by: Vester Gravley on Friday, November 18, 2016 Posted in: CMS, readmission penalties, readmissions

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A recent FierceHealthcare article suggests that, in addition to the 30-day readmission penalties imposed by CMS, the agency should begin to levy penalties for 30-day post discharge mortality rates. The article cites heart failure cardiologist and senior study author Scott Hummel, M.D., who observed that “Under most circumstances, hospital patients would much rather avoid death than readmission. But the incentive to prevent death in the first 30 days after a hospitalization is 10 times less than the incentive to prevent a return hospital visit.”

Frankly, I’m confused. Are the authors of the study suggesting that hospitals are “preventing” patient readmissions to the point of negligent homicide? That would be crazy! The basic assumption drawn from the study seems to be that patient mortality within 30 days of discharge indicates a lapse in care quality and should therefore be included in the care quality metric used to calculate penalties. What if I get hit by a bus on day twenty-nine post discharge? Does that factor in as well? Any traction found by this idea will certainly favor CMS, according to author Morrie Schwartz who observes: “Everything that gets born dies.”

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