Medicare's penalty program for excess hospital readmissions is among its most tenacious efforts to increase quality of care. Penalties are evaluated based on findings from Medicare's comprehensive measure of hospital readmissions and are reviewed annually.
Medicare has been tracking hospital readmission rates for heart failure, heart attack and pneumonia patients since 2008 and began implementing penalties in 2012. These readmissions rates are important because the Medicare Payment Advisory Commission advises lawmakers to take account of these measures when determining financial penalties for hospitals in the Readmissions Reduction Program. As of Oct. 1, 2013, Medicare has implemented fines to 2,225 hospitals for excess readmissions for heart failure, heart attack, and pneumonia patients.
Medicare's readmissions measures have been met with contestation by some hospital industry professionals and independent researchers, pointing out that the measures do not reflect that hospitals can save lives by assertively readmitting patients at early signs of complication. They also point out that hospitals that serve large populations of low-income patients will likely have higher readmissions rates because many of those patients do not have a primary care physician, and lack the resources necessary for proper follow-up care.
The following is a list of cities that have the most hospitals with readmission rates exceeding the national average, according to an analysis by Kaiser Health News.
Chicago: 19 hospitals including Northwestern Memorial Hospital, Rush University Medical Center and the University of Chicago Medical Center.
Brooklyn: 11 hospitals including Brookdale Hospital and Medical Center, Kingsbrook Jewish Medical Center and New York Methodist Hospital.
Philadelphia: 10 hospitals including Einstein Medical Center, the Hospital of the University of Pennsylvania and Thomas Jefferson University Hospital.
Baltimore: Seven hospitals including The Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center, MedStar Good Samaritan Hospital and the University of Maryland’s Medical Center and Midtown Medical Center.
Manhattan: Seven hospitals including Beth Israel Medical Center in Manhattan, Lenox Hill Hospital, New York-Presbyterian Hospital and NYU Langone Medical Center.
Boston: Five hospitals: Beth Israel Deaconess Medical Center, Boston Medical Center, Brigham and Women’s Hospital and the Brigham’s Faulkner Hospital, and Tufts Medical Center.
Los Angeles: Four hospitals: California Hospital Medical Center, Hollywood Presbyterian Medical Center, Olympia Medical Center and Ronald Reagan UCLA Medical Center.
Miami: Four hospitals: Jackson Memorial Hospital, Kendall Regional Medical Center, University of Miami Hospital and Westchester General Hospital.