CMS is planning to improve its method of rating quality at the nation’s nursing homes, and that can only be good news for the hospital field and the effort to reduce readmissions.
CMS recently announced details on changes to its Nursing Home Compare ratings website. The changes parallel provisions of the Improving Medicare Post-Acute Care Transformation Act of 2014, which was signed into law Oct. 6.
The agency anticipates it will improve some of its Five-Star Quality Rating System data metrics, focus more on the higher-quality data it collects when calculating its ratings and add to the number of measures included in the rating. The improvements are welcome, a recently published study indicates there is no association to be found between available performance measures and the risk of readmission.
Hospitals already are working hard to reduce readmissions by getting closer to their post-acute care partners. For a recent story that’s part of a series I’m writing on the aging of the boomer generation, officials at the University of Pittsburgh Medical Center described how they’re using dedicated nurse practitioners to manage clinical relationships with its skilled nursing facility partners.
That kind of activity is great, but won’t necessarily be able to be replicated across the country. For a variety of reasons, such as lack of resources, many hospitals for now are at the mercy of their community’s post-acute providers. If a nursing home’s quality lags, a recently discharged patient may end up back in the hospital and accrue financial penalties for the discharging hospital.
The changes, if effective, will come too late to limit the damage of reimbursement penalties this government fiscal year and next. The CMS penalty for readmission rose to 3 percent of payments on Oct. 1 for the current government fiscal 2015. Readmission penalties from the previous fiscal year will result in penalties totaling $428 million in the current fiscal year, according to Kaiser Health News.
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