PORTLAND, Maine — The Centers for Medicare & Medicaid Services (CMS) last week released data on U.S. hospitals’ performance under its pay-for-performance readmission program. The results of data collected from 2010 to 2013 show MaineHealth members leading the state in both overall scoring and making improvements in this area.
In the release, which reveals Medicare adverse reimbursement adjustments of up to 3 percent for thousands of hospitals based on readmissions to the facilities within a 30-day period, Maine Medical Center in Portland and Southern Maine Medical Center in Biddeford (now known as Southern Maine Health Care) for the third consecutive year will not be penalized. These are the only two facilities in the state that have three consecutive years without an adjustment under this program.
More than 2,600 hospitals nationwide will receive a reduction in Medicare funding, enforced from October 1, 2014, to September 30, 2015.
“We are focused on reducing readmissions across the system for a number of reasons, and most important is that we want our patients to be able to go home on a path to recovery, confident that they’re getting better,” said Robert McArtor, M.D., chief medical officer, MaineHealth. “We are proud that our organizations’ continued commitment to high-quality care leads to the outcomes that help us score favorably in these types of assessments.”
In addition to the continued excellence demonstrated by MMC and SMMC, Pen Bay Medical Center in Rockland showed the most improvement under the readmission program, reducing their total penalty by nearly 10 percent.
“All of our MaineHealth members continuously strive for excellence and support the efforts of CMS to improve care and transparency for all health care consumers,” said Dr. McArtor. “We applaud the efforts that have led to our successes in this area while recognizing that improving patient care is a never-ending journey and that even the most successful organizations can get better.”
According to a report from Kaiser Health News, “To determine each hospital’s penalty, CMS calculated an excess readmission rate for patients who first went into the hospital for three conditions: heart failure, heart attack and pneumonia. The agency based the rate on discharges occurring from [the third quarter of 2010 to the second quarter of 2013]. CMS took into account the severity of illness of each hospital’s patients in estimating what the hospital’s readmission rate should have been given the national averages. If a hospital had fewer than 25 cases for heart failure, heart attack or pneumonia, CMS did not include that condition in its analysis, but hospitals could still receive a penalty if they had 25 cases or more in one of the other conditions.”
“Avoiding readmissions involves providing the right care in the hospital, making sure the patient is ready for discharge, and having coordinated care and follow up in the appropriate setting when the patient leaves the hospital,” said D. Joshua Cutler, M.D., vice president, Quality & Safety, Maine Medical Center. “To achieve this status with CMS a hospital has to perform exceptionally favorably against national averages, which is what makes the performances of MMC and SMMC so remarkable.
“The ongoing success of these two organizations — and the improvements made at Pen Bay — are a testament to the abilities, compassion, and coordination of all our staff, both clinical and nonclinical.”
MaineHealth is a not-for-profit family of leading high-quality providers and other healthcare organizations working together so their communities are the healthiest in America. Ranked among the nation's top 100 integrated healthcare delivery networks, MaineHealth member organizations include Maine Medical Center, LincolnHealth, Maine Behavioral Healthcare, Memorial Hospital, Pen Bay Healthcare, Southern Maine Health Care, Waldo County Healthcare, Western Maine Health, Franklin Community Health Network, HomeHealth Visiting Nurses, Maine Physician Hospital Organization, NorDx and Synernet. Affiliates of MaineHealth include MaineGeneral Health, Mid Coast Health Services, New England Rehabilitation Hospital of Portland and St. Mary's Health System.
Monday, October 6, 2014
Contact: Matt Paul, firstname.lastname@example.org