Case Management

Mentor moment: CMS eyes Readmission Payment Reduction Program expansion

Case Management Weekly, June 29, 2011

It appears that CMS is beginning to plan an expansion of the Readmission Payment Reduction Program. 

The Readmission Payment Reduction Program, which will becomes effective at the start of FY2013, will reduce the aggregate DRG payments to hospitals that have a high readmission rate for three select conditions—acute myocardial infarction , heart failure, and pneumonia.

However, CMS announced June 9 that it is accepting comments on a new measure currently in development, “Hospital-Level 30-Day All-Cause Risk-Standardized Readmission Rate following Vascular Procedures.” 

“I know [CMS] want[s] to expand the readmission reduction program from the current rule so this is the way they would do it—announce and ask for public comment and then finalize,” says Debbie Mackaman, RHIA, CHCO, regulatory specialist at HCPro, Inc., in Danvers, MA.

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