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Two Area Hospitals Penalized For Re-Admitting Too Many Medicare Patients

A picture of an elderly person's hand with an I.V. tube taped to it.
Tim Samoff

Two Triangle hospitals will lose a portion of their Medicare reimbursements this year. They're being penalized for re-admitting too many patients within a month of hospitalization.

Under the Affordable Act, the Centers for Medicare and Medicaid Services reduce payments to hospitals which re-admit a higher number of patients than they're supposed to. They're looking at data between the summers of 2010 to 2013. Based on the number re-admissions, the CMS determines what percentage of Medicare reimbursement to withhold.

It's the third year of the Hospital Readmissions Reduction Program, and the maximum penalty has risen from two- to three-percent. They're looking at data between the summers of 2010 to 2013. 

Kaiser Health News published a list of the 2015 Medicare re-admissions penalties by hospital.

The program also expanded the number of conditions evaluated from readmissions: they used to look at heart attack, heart failure, and pneumonia patients. This year, they added chronic lung problems and knee-and-hip replacements to the list.

Duke Raleigh Hospital will lose 1.43 percent of Medicare reimbursements in the coming year. Officials there couldn't be reached for comment.

WakeMed in Cary is being penalized for the first time this year. They'll lose only .55 percent in reimbursements. 

Spokeswoman Kristin Kelly wrote in an e-mail that the Cary Hospital was only penalized for joint replacement readmissions. She added that the analysis doesn't consider new programs the hospital has implemented to cut down on readmissions. 

Rebecca Martinez produces podcasts at WUNC. She’s been at the station since 2013, when she produced Morning Edition and reported for newscasts and radio features. Rebecca also serves on WUNC’s Inclusion, Diversity, Equity and Accountability (IDEA) Committee.
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