Ilovebenefits’s Blog

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Saving Healthcare Dollars: Hospital Readmissions

Editor’s note: The cost conundrum is that health care stakeholders are paid to take care of sick people. Getting them well, does not serve their business model.


Reducing readmissions is not an easy goal to achieve
Health care experts and lawmakers agree hospitals must reduce readmissions, but accomplishing that goal is complicated. Some facilities use nurses and doctors to follow up on recently discharged, very ill patients, but some patients aren’t willing or able to follow the advice. Several lawmakers are looking to lower reimbursement for facilities that have high readmission rates. The Wall Street Journal


July 28, 2009 - Posted by | Cost, healthcare, quality | , ,

1 Comment »

  1. It isn’t entirely true that health care providers are paid more if they have more sick people. Hospitals get paid per procedure or hospitalization day (provided the procedure/hospitalization is justified), so it is in their best interest to a) stay at full capacity and b) only provide services that are approved by the members’ health management groups.

    Healthplans have to pay for each patient admission, so they research which hospitals are most effective at preventing readmissions. Better hospitals can negotiate higher reimbursement rates from private health management companies and can in the end make more money (or as much money) by being more efficient compared to being less efficient with more admissions. It sounds like, from the WSJ article, that the government is not currently able to negotiate reimbursement rates with hospitals, so, for the moment, it is true that hospitals that deal largely with Medicare-covered patients have little incentive to reduce readmissions.

    Comment by pmv | July 28, 2009 | Reply

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