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Five Florida Hospitals Face Maximum Medicare Readmission Rate Penalty

Oct 7, 2019

The Centers for Medicare and Medicaid Services will penalize 2,583 hospitals nationwide for having too many Medicare patients readmitted within 30 days, according to federal data analyzed by Kaiser Health News.

Five Florida hospitals will get the maximum penalty of a 3% cut to reimbursement rates. The minimum is 0.01%.

Infographic showing five Florida hospitals that are getting the maximum penalty for having too many Medicare patients readmitted within 30 days. GRAPHIC BY DAYLINA MILLER/WUSF PUBLIC MEDIA

The hospitals penalized are Palms of Pasadena in St. Petersburg, Lakeland Regional Medical Center, Raulerson Hospital in Okeechobee, St. Lucie Medical Center in Port St. Lucie, and St. Vincent's Medical Center Southside in Jacksonville.

The federal government penalizes hospitals with high readmission rates in an effort to reduce the number of patients who return for a second hospital stay within a month.

RELATED CONTENT: 39 Florida Hospitals Penalized With Medicare Cuts

Proponents of the penalties – which have been ongoing since 2012 as part of the Affordable Care act – say it forces hospitals to have better follow up care and help patients get medications.

Critics say it encourages hospitals to avoid readmitting patients who need it.

The penalties are based on the frequency of readmissions of Medicare patients who had originally been treated for heart failure, heart attack, pneumonia, chronic lung disease, hip and knee replacement or coronary artery bypass surgery.

Readmissions that were scheduled to occur are not counted.

Hospital Reactions

From Caroline Gay, FHFMA, Lakeland Regional Health Chief Population Health Officer/Chief Analytics Officer:

At Lakeland Regional Health, we are steadfast in our commitment to reduce readmissions by focusing on expanding the continuum of care, increasing access to quality care, strengthening the health of our community and focusing on population health needs of our community.

Hospital readmissions are a multifaceted problem. Medicare presents readmission rates as an objective measure of hospitals, but there are so many complex variables not taken into account, such as areas that struggle socioeconomically and physician shortages. Polk is the sixth-poorest suburban county in the country, according to the Brookings Institution. Our area is 30% shy of primary care for every 100,000 persons.

Penalizing hospitals with higher rates year after year could actually be exacerbating the problem. What if those millions of dollars are instead invested in our community programs and getting people access to physicians? We could be working together to create a totally different healthcare picture.

From Debra McKell, Marketing Director, HCA West Florida Division

“Palms of Pasadena is committed to providing our patients with high quality healthcare services in a warm, personalized environment.  We work with each patient to create a care plan with the goal of a successful recovery and discharge.  There are multiple metrics and quality measures used to compare hospitals and we strive to excel in all areas, but the care of our patients remains our top priority."