Readmission Penalty of Accountable Care Organizations
For the second part of my research, I took a look at the readmission penaltyindividual hospitals received for having high readmission rates. I specifically looked at established ACO organizations and I compared them to well known non – ACOs. Hospitals are now being penalized for having high readmission rates and can thus lose as much as 1% (in 2012, more in upcoming years) of their Medicare reimbursement as a direct result. Below you will find the readmission penalties of the most well known ACOs and non-ACOs. Additional readmission data can be found on Medicare’s website.
Readmission Penalty
ACO Readmission Penalties
Beth Israel Deaconess – 1%
Brigham and Womens – 0.56%
Dartmouth-Hitchcock / Cigna – 1%
Doctors Medical Center Modesto / Blue Cross Blue Shield – 0.62%
Montefiore – 1%
Hoag Hospital / Blue Cross Blue Shield – 1%
Methodist Hospital Dallas / Texas Health Resources – 0.22%
Norton Hospital / Humana – 0.16%
St. Joseph Hospital California / Blue Cross Blue Shield – 0.32%
Average ACO Readmission Rate: 0.65%
Non-ACO Readmission Rates
Centennial (HCA) – 0%
Emory University Hospital – 0%
Massachusetts General Hospital – 0.53%
Ochsner Health System – 0.83%
Touro Infirmary – 0.%
Tulane Medical Center (HCA) – 0%
University of Alabama Birmingham – 0.16%
University of Kentucky -0.35%
University of California San Francisco – 0.09%
Vanderbilt University Medical Center – 0.60%
Average Non-ACO Readmission Penalty: 0.26%
Readmission Penalty of Accountable Care Organizations are high!
As you can see from the above results, ACOs have higher readmission penalties than Non-ACOs. It is not entirely clear as to why these rates are higher than Non – ACOs. More research is needed to thus determine the exact cause. As a result of these high penalties, the ACOs will in fact be losing a large amount of their Medicare reimbursement this year. The next part of my research will focus upon the penalty ACOs and Non-ACOs can lose for having high readmission rates. For complete results of my research, please read the post titled “Accountable Care Organizations are Failing”.
