September 30, 2012

ATTAINING THE CONSERVATIVE GOAL OF ACCOUNTABILITY:

Medicare fines over hospitals' readmitted patients (RICARDO ALONSO-ZALDIVAR, 9/29/12, Associated Press)

If you or an elderly relative have been hospitalized recently and noticed extra attention when the time came to be discharged, there's more to it than good customer service.

Starting Monday, Medicare will fine hospitals that have too many patients readmitted within 30 days of discharge due to complications. The penalties are part of a broader push under President Barack Obama's health care law to improve quality while also trying to cut costs. [...]

It adds up to a new way of doing business for hospitals, and they have scrambled to prepare for well over a year. They are working on ways to improve communication with rehabilitation centers and doctors who follow patients after they're released, as well as connecting individually with patients.

"There is a lot of activity at the hospital level to straighten out our internal processes," said Nancy Foster, vice president for quality and safety at the American Hospital Association. "We are also spreading our wings a little and reaching outside the hospital, to the extent that we can, to make sure patients are getting the ongoing treatment they need."

Those of us who get our health insurance through King Arthur Flour (Norwich, VT) also just got a tidy rebate because Cigna failed to cut its bureaucratic costs, Cigna must refund $2.3 million to Vermont customers (Alan Panebaker, June 21, 2012, VT Digger)

Cigna, a major health insurer of large businesses in Vermont, is on the hook for more than $2 million that it must return to its customers in the state under a provision of the federal health care law.

According to numbers released Thursday by the U.S. Department of Health and Human Services, 4,636 Vermonters will receive a rebate -- averaging out to $807 per family.

The rebate is required under a section of the federal Affordable Care Act which requires insurance companies to spend at least 80 percent (or 85 percent in the large group market which is generally insurance through large employers) on medical care.

If insurance companies do not meet this requirement, they have to refund the portion of the premium that exceeded the 20 or 15 percent limit on things like administrative expenses.
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Posted by at September 30, 2012 9:10 AM
  
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