FAIRMONT - Mayo Clinic Health System in Fairmont is facing the largest penalty in Minnesota for readmission of Medicare hospital patients, under the federal Affordable Care Act.
Looking at hospital records from June 2008 through June 2011, Centers for Medicare and Medicaid Services is penalizing health care facilities across the country that readmitted too many Medicare patients with health failure, heart attacks and pneumonia within 30 days of their discharge.
The Fairmont hospital will lose 0.81 percent of its payments for Medicare discharges starting Oct. 1.
"It's not huge, but in this environment, every dollar does count," said Bob Bartingale, administrator for the local Mayo site. He estimates about 60 percent of the hospital's patients are on Medicare.
The challenges in lowering readmission rates are many, and the Fairmont site is working to address them, said Dr. Marie Morris, chief medical officer.
Education is a key component. Patients need to be prepared to return home, so hospitals have to make sure individuals understand their disease, potential complications, medication side effects, and the importance of follow-up, Morris said.
Penalized hospitals' readmission rates were not made public, but Bartingale did say since 2010, Fairmont's numbers have improved, with the readmission rate dropping from 17 percent to 13 percent this year. He partially credits the facility's hospitalist model for that improvement.
"Having a physician in the hospital 24 hours a day continues to help us," he said.
According to Kaiser Health News, Medicare took into account the sickness of the patients when calculating whether a hospital's rates were higher than average, but not patients' racial or socio-economic background. Morris could not say if Fairmont's demographics potentially played a part in the local hospital's higher readmission rates.
"We haven't distinguished our population that way," she said. "We treat everyone the same regardless of ability to pay or their insurance plan. I don't think we can speak to their ability to manage their self-care."