City | 8:41 am | August 17, 2012 | By Ben Prawdzik

Conn. hospitals to lose some Medicare funds

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Photo by Sergio Zenisek.

Twenty three of Connecticut’s 29 acute-care hospitals, including Yale-New Haven Hospital, will lose Medicare funds next year due to a provision of the 2010 health care law that penalizes hospitals with high patient readmission rates.

Four of the 23 hospitals will lose 1 percent of their base Medicare reimbursements — the maximum penalty possible under the provision. These include the Hospital of St. Raphael in New Haven, which Yale-New Haven acquired in July for $160 million, Griffin Hospital in Derby, Masonic Home and Hospital in Wallingford, and MidState Medical Center in Meriden.

Three others hospitals — Yale-New Haven, Bristol Hospital and St. Vincent’s Medical Center in Bridgeport — will lose close to the maximum amount, according to data compiled by the Centers for Medicare and Medicaid Services.

The penalties come from a specific provision of the Patient Protection and Affordable Care Act known as the Hospital Readmission Reduction Program (HRRP). The HRRP targets hospitals with higher than average patient readmission rates for certain medical conditions, including heart failure and pneumonia. Under the provision, readmission occurs if a patient is discharged from an acute-care hospital and is subsequently readmitted within 30 days.

The HRRP allows the Centers for Medicare and Medicaid Services to withhold a maximum of 1 percent of Medicare payments to hospitals with excessive readmission rates starting in fiscal year 2013. The penalty cap will rise to 3 percent in 2015, which could result in millions of dollars of losses for some hospitals.

Nationwide, more than 2,200 acute-care hospitals will be penalized by the Center for Medicare and Medicaid Services based on readmission data taken between July 2008 and June 2011. According to the American Hospital Association, there are 5,754 acute-care hospitals in the United States, and a total of 278 hospitals will lose the maximum 1 percent of their Medicare funding possible under the law.

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