Hospital Readmission and Hospital-Acquired Conditions – The Financial Impact
Readmission Rate Trends
Mount Carmel East & West has experienced fluctuating readmission penalty rates from 2020 to 2023. The rate increased sharply from 0.23% in 2020 to 0.71% in 2021, likely due to COVID-19 challenges. In 2022, there was slight progress as the rate went down to 0. 21%. However, it rose again in 2023 to 0.53%, showing that there are still challenges in consistently sustaining the reduction of readmissions (Rau, 2022). This instability indicates that the hospital has not been consistent in its performance of avoiding readmissions.
Hospital-Acquired Conditions
Hospital-acquired conditions (HACs) are also a major concern. Though it was free from penalty in the year 2020, Mount Carmel East & West was penalized in 2021 and 2022. The HAC exemption in 2023 might be attributed to the fact that CMS had removed HAC penalties during the public health emergency year (CMS, 2023). This trend raises concerns relating to patient safety throughout the given period.
Financial Implications
The HAC penalties, which range from a 1% loss of their Medicare payments, are likely to affect the revenue of the concerned hospital. However, beyond these fines, HACs are associated with higher treatment costs, longer patient stays, and probable legal fees (Waxman & Knighten, 2022). Possible solutions that the hospital may apply include staff training, new safety measures, and new technologies to mitigate challenges like these, which would translate into further short-term costs.
Organizations Impact
The financial consequences are not limited to one’s pocket as they include further consequences. Some potential business risks of having a bad reputation include reduced patient confidence and market share. These impacts could lead to long-term adverse effects on its financial position as well as its ability to attract patients and talented medical practitioners (Rau, 2018; Rau, 2019). Conclusively, Mount Carmel East & West faces significant challenges in consistently reducing readmissions and preventing HACs.
References
CMS. (2023). Hospital Readmissions Reduction Program (HRRP) | CMS. Www.cms.gov. https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/hospital-readmissions-reduction-program-hrrp
Rau, J. (2018, September 26). Medicare Eases Readmission Penalties Against Safety-Net Hospitals. KFF Health News. https://kffhealthnews.org/news/medicare-eases-readmissions-penalties-against-safety-net-hospitals/
Rau, J. (2019, March 1). Medicare Trims Payments To 800 Hospitals, Citing Patient Safety Incidents. KFF Health News. https://kffhealthnews.org/news/medicare-trims-payments-to-800-hospitals-citing-patient-safety-incidents/
Rau, J. (2022, October 31). Look Up Your Hospital: Is It Being Penalized by Medicare? KFF Health News. https://kffhealthnews.org/news/hospital-penalties/
Waxman, K., & Knighten, M. L. (Eds.). (2022). Financial and business management for the doctor of Nursing practice (3rd ed.). Springer Publishing Company. https://doi.org/10.1891/9780826160164
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Question 
For this discussion, you will need to review the Centers for Medicare and Medicaid information on the Hospital Readmissions Reduction Program (HRRP). Links to an external site.. You will also need to navigate to the Kaiser Family Foundation Penalty Tracker site.
Hospital Readmission and Hospital-Acquired Conditions
While at this site, look up your organization: https://khn.org/news/hospital-penalties/Links to an external site.
If you are not working for a hospital, look up your nearby hospital.
Report on the following:
Click on the Readmission tab. Examine the readmission rate trend from 2020 to the present. What does this data convey about the organization’s ability to reduce readmission rates?
Click on the Hospital-Acquired Conditions tab. Has the organization been penalized for hospital-acquired conditions from 2020 to the present? What type of costs do you perceive that the organization might incur related to the hospital-acquired conditions (HACs) shown on the KFF site?
What impact might the penalties associated with HACs have on the organization?
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