State to penalize hospitals that readmit too many patients

By Liz Kowalczyk, Globe Staff

Starting next month, the state plans to cut Medicaid payments to 24 hospitals that it says have higher-than-average rates of readmitting patients.

When a patient returns to the hospital soon after going home, it can mean that the hospital provided inadequate instructions on taking medications, or failed to follow-up on problematic test results.

By docking the pay of hospitals that readmit high numbers of patients within 30 days of discharge, state officials hope to push hospitals to better coordinate patients’ care after they leave the hospital. Massachusetts Medicaid officials, who plan to reduce reimbursements to these hospitals by 2.2 percent, estimate the program will save $5.2 million in the fiscal year that begins Oct. 1.

The Massachusetts Hospital Association said the plan is unfair. The group sent a letter to Medicaid Director Dr. Julian Harris last week outlining its objections.

“There are readmissions the hospital can’t control,’’ said Timothy Gens, executive vice president and general counsel. Sometimes, for example, patients do not take their medications or seek follow-up care, despite thorough training from hospital staff.

He also criticized the data the state is using to calculate “potentially preventable readmissions’’ as being old -- from 2009 -- and said hospitals haven’t been given sufficient time to verify the data.

The hospitals slated for the 2.2 percent cut are: Beth Israel Deaconess Hospital-Needham, Nashoba Valley Medical Center, Noble Hospital, Milton Medical Center, Marlborough Hospital, North Adams Regional Hospital, Heywood Hospital, Anna Jaques Hospital, Sturdy Memorial Hospital, Quincy Medical Center, Morton Hospital, Saint Anne’s Hospital, Norwood Hospital, Saint Vincent Hospital, St. Elizabeth’s Medical Center, South Shore Hospital, Good Samaritan Medical Center, MetroWest Medical Center, Brockton Hospital, Cambridge Health Alliance, Tobey Hospital, Tufts Medical Center, Brigham and Women’s Hospital, and Boston Medical Center.