Less than two weeks after Franklin Memorial Hospital was named to a list of hospitals to be penalized for high patient readmission rates, another report says the Farmington hospital's readmission rates are better than most.
The Program for Evaluating Payment Patterns Electronic Report, or PEPPER, is put out by the TMF Health Quality Institute. According to the group's website, it does this work under contract with the Centers for Medicare & Medicaid Services to provide comparative data to hospitals.
A PEPPER list recieved by Franklin Memorial this week shows the hospital's 30-day readmission rates for all Medicare patients have been consistently lower than the national and regional average since 2009. And despite a few spikes, most of the time its readmission rates have been the same as or lower than other hospitals in the state.
"We're actually in a good place," said Gerald Cayer, executive vice president of the Franklin Community Health Network, which runs Farmington's Franklin Memorial Hospital. "What you can see is Franklin actually does a pretty decent job with 30-day readmissions."
Franklin Memorial is one of 10 hospitals statewide and one of more than 2,000 across the country set to be penalized by the government because too many of its Medicare patients were readmitted soon after discharge. The penalties are based on the frequency that Medicare heart failure, heart attack and pneumonia patients were readmitted to any hospital, for any reason, within 30 days between July 2008 and June 2011.
PEPPER looked at all Medicare patients, not only those admitted for specific illnesses. It considered readmissions between mid-2009 and mid-2012.
Medicare's penalties will be deducted from reimbursements each time a hospital submits a claim starting Oct. 1. Franklin Memorial's penalty will be 0.16 percent. That's about $12 per Medicare patient, or $13,300 total.
Cayer said his hospital has been working on readmission rates for more than a year-and-a-half, with a focus on getting patients follow-up care and making sure they understand their medical needs and medications before they leave the hospital.
He said Medicare's own numbers show Franklin Memorial was under the readmission cap in two of the three categories — heart failure and pneumonia — and it only missed the cutoff for heart attack readmission by four patients over that three-year period. One of those, he said, was a patient admitted to another hospital for chemotherapy, a treatment that had nothing to do with the patient's original stay at Franklin Memorial
He also feels it's unfair for Medicare to penalize the hospital for readmission rates that occurred four years ago.
"From an administrative perspective, this is more about addressing a federal budget deficit issue than really promoting quality," he said. "It's a way for Medicare to take funds back."
The Centers for Medicare & Medicaid Services did not return calls seeking comment by deadline.
While Medicare considered data between 2008 and 2011, PEPPER looked at data between 2009 and 2012. Cayer believes that more accurately gauges where the hospital stands now.
"I was thrilled because it validated for me our local experience around 30-day admissions," he said.