Many Oregon hospitals continue to be financially penalized by the federal government for frequent readmission of sick patients, with a handful of them sanctioned for high rates of patient injuries or infections.
The penalties stem from two annual federal monitoring programs that reduce Medicare payment rates to hospitals that flunk federal standards for patient readmissions and hospital-acquired illnesses.
Of the 65 Oregon hospitals monitored for readmissions, 25 were dinged financially for the fiscal year starting Oct. 1. The federal Medicare program cuts payments by as much as 3% for each patient, although the average is generally much lower.
For safety and sickness problems, the government cuts Medicare payments by a flat 1% for the year. Congress sets Medicare payment rates.
Since its inception in 2015, the penalty program has clamped down on Medicare payments to thousands of hospitals nationwide.
In the latest round, four Oregon hospitals are having their Medicare payments cut by 1% for safety problems: Legacy Meridian Park Medical Center, a 120-bed hospital in Tualatin; Providence Newberg Medical Center, a 40-bed hospital; Salem Hospital, a 494-bed facility; and St. Charles Redmond Medical Center, a 48-bed hospital.
(See also: Medicare Fines Half of Hospitals for Readmitting Too Many Patients.)
Just how much the penalty squeezes a hospital depends on how many Medicare patients a hospital handles, and that can vary widely. Medicare patients total about 42 percent of a typical hospital’s patients, according to the American Hospital Association. Hospital executives contend that Medicare patients typically are a financial money-loser. The association says that Medicare pays hospitals only about 87% of the true cost of caring for these patients. But almost all hospitals accept them because a hospital’s mission is to heal, it wants the revenue and it must accept Medicare patients if it wants to keep its federal nonprofit status. All but two Oregon hospitals are nonprofits.
Readmissions are seen as a problem if they occur within the first few days after discharge, according to the National Institutes of Health. Readmission may reflect poor care coordination or poor post-discharge care, the agency says.
The penalties for readmissions in Oregon varied widely. The highest penalties were levied on 49-bed Asante Ashland Community Hospital, with a 2.35% cut; Sky Lakes Medical Center, 176 beds in Klamath Falls, a 1.89% cut; 150-bed Adventist Health Portland, 1.09% cut; 174-bed Mercy Medical Center, Roseburg, 1.01% cut; and 59-bed Providence Milwaukie Hospital, 0.95% cut.
Other hospitals taking Medicare payment cuts: Providence Medford Medical Center, 0.73%; Willamette Valley Medical Center, McMinnville, 0.35%; Mid-Columbia Medical Center, 0.34%; Sacred Health Medical Center RiverBend, Springfield; 0.31%; St. Charles Redmond, 0.28%; Legacy Emanuel Medical Center, Portland, 0.23%; Saint Alphonsus Medical Center Ontario, 0.23%; McKenzie-Willamette Medical Center, Springfield, 0.17%.
The following hospitals are taking payment cuts ranging from 0.14% to 0.01%:
Providence Willamette Falls Medical Center, Oregon City; Legacy Silverton Medical Center; Legacy Good Samaritan Medical Center; Oregon Health & Science Hospital and clinics; and Samaritan Albany General Hospital.
You can reach Christian Wihtol at [email protected].
