Did you or someone you care for get a little extra attention when you checked out of the hospital recently? If so, it's likely because starting today hospitals will be fined if they have too many Medicare patients readmitted to the hospital within 30 days of being discharged.
The fines are part of the health care reform law, and are an attempt to both improve quality and reduce costs. Nearly 2 million Medicare patients are readmitted each year, costing Medicare $17.5 billion in additional hospital bills.
About two-thirds of the hospitals serving Medicare patients, or some 2,200 facilities, will be penalized this year, with an average fine of about $125,000, according to government estimates. Hospitals in Arkansas, the District of Columbia, Illinois, Kentucky, Massachusetts, Mississippi, New Jersey, and New York will be among the hardest hit, according to reports. For now, hospitals are only being measured on three medical conditions: heart attacks, heart failure and pneumonia.
Medicare plans to post details later this month on individual hospitals on its HospitalCompare.gov website. And over the past year, a number of hospitals have taken steps to reduce readmission rates. But our hospital Ratings show that many hospitals need to improve.
"Some readmissions are to be expected since disease can progress or recur," says John Santa, M.D. director of the Consumer Reports Health Ratings Center. "But many readmissions are preventable especially those related to errors during your hospitalization or poor communication at the time of discharge," he said.
Here are some tips, from our medical experts, on how to avoid unnecessary readmissions:
- Don't go home before you're ready. Usually the sooner you get home the better. But you shouldn't be discharged if you feel disoriented, faint, or unsteady; have pain that's not controlled by oral medication; can't go to the bathroom alone; have trouble urinating or moving your bowels; or can't keep food or drink down.
- Identify a specific person to call (usually the doctor responsible for you care) if you have questions about your hospital stay or what to do next.
- See a discharge planner well in advance of your departure to arrange for services or supplies you'll need at home.
- Get a written summary of what to do when you get home, including drugs you need, how to care for wounds, how active you can be, and when you can shower, drive, return to work, and eat normally.
- Get results of tests done while in the hospital and ask what tests you'll need after you leave and when you'll need them.
- See your primary-care doctor within 10 days of going home.
For more tips on staying safe in the hospital, see our Hospital Survival Guide. And see our story How Safe Is Your Hospital and our hospital Ratingsfor information on how hospitals in your community score in preventing readmission and other key performance measures.