Most NJ Hospitals Penalized Under A Program To Reduce Avoidable Readmissions

STATE – Most New Jersey hospitals will pay a penalty under a federal program intended to improve patient care under Medicare, according to an analysis by Kaiser Health News.

The penalties reduce the per-patient payments the hospitals receive under Medicare, and are applied to hospitals where patients were most likely to be readmitted after 30 days.  The program, which took effect last year, is part of the Patient Protection and Affordable Care Act signed into law in 2010.

New Jersey is one of 10 states where at least four out of five hospitals are subject to the penalties. Just five of 64 Garden State hospitals will pay no penalty, though 36 will see their penalties decrease from last year.

Among local hospitals:

  • JFK Medical Center in Edison will pay a 0.35% penalty, down from 0.43% last year
  • Overlook Hospital in Summit will pay no penalty for the second year in a row
  • Raritan Bay Medical Center in Perth Amboy will pay a 1.37% penalty, up from 1.00% last year
  • Robert Wood Johnson University Hospital in New Brunswick will pay a 0.73% penalty, down from 0.80% last year
  • Robert Wood Johnson University Hosptial at Rahway will pay a 0.34% penalty, down from 1.00% last year
  • Saint Peter’s University Hospital in New Brunswick will pay a 0.73% penalty, down from 1.00% last year
  • Trinitas Regional Medical Center in Elizabeth will pay a 0.72% penalty, down from 0.74% last year.
  • University Medical Center at Princeton in Plainsboro will pay a 0.15% penalty, down from 0.25% last year

According to the Medicare Payment Advisory Commission, up to 12 percent of Medicare patients may be readmitted for potentially avoidable reasons. If one in 10 of those readmissions could be prevented, Medicare could save an estimated $1 billion.

It is unclear what the exact financial impact of the penalties is on individual hospitals, since they are applied to every payment for a patient stay and can only be estimated in advance.

So-called “safety net hospitals” that have more poor patients were more likely to be penalized under the program. While just 36 percent of the hospitals with the fewest poor patients were penalized, 77 percent of those with the most poor patients were penalized, according to the Kaiser Health News analysis.

Low income patients often have a harder time following post-discharge instructions do to the cost of medicines or dietary changes.

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