Elbert Memorial Faces Medicare Readmission Penalties

August 12, 2013

Seventy-three hospitals in the state of Georgia are facing fines from Medicare for excessive readmissions of patients within thirty days of discharge.

Elbert Memorial Hospital is one of those seventy-three, and CEO Jim Yarborough says a majority of readmissions are out of the hospital’s control.

“There’s often cases where the hospital has no control, and a lot of it has to do with the patient’s non-compliance with their physicians instructions once they are released from the hospital”, said Yarborough.

Under Medicare’s Readmission Penalty Program, Elbert Memorial Falls under the one percent penalty category, and Yarbrough explains what that means financially for Elbert Memorial.

“We’re in the one percent category, and I think the maximum penalty was two percent reduction in reimbursement, which equates to roughly a twenty thousand dollar annual reduction”, explained Yarborough.

He says this program was started to encourage hospitals to keep better tabs on their patients once they leave the hospital, and he says that is exactly what Elbert Memorial is doing.

“We have a lot of internal programs that we are trying to implement to work with patients, their families, or their care givers at time of release from the hospital”, said Yarborough. “We are actually following up with phone calls with certain patients to make sure they are following up with their doctors and that they are taking their medications.”

In Fiscal Year 2013, Elbert Memorial faced an even one percent readmission penalty, but moving ahead into Fiscal Year 2014, that penalty increased by just over a half of a percentage point to a 1.52% readmission penalty.

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