Local hospitals dinged by Medicare

Dec. 20--Hospitals run by the Lehigh Valley's biggest health care providers have been penalized by the federal government because patients developed preventable complications while being treated at their facilities.

Lehigh Valley Hospital's Salisbury, Allentown and Bethlehem locations and St. Luke's University Hospital in Bethlehem, as well as the Surgical Specialty Center At Coordinated Health in Allentown are among more than 700 hospitals across the country whose Medicare reimbursement rates will be cut by 1 percent, the Centers for Medicare and Medicaid Services, or CMS, announced Thursday.

The penalties, part of a program implemented under the Affordable Care Act, are intended to spur better treatment at the nation's hospitals, thereby lowering spending on hospital-acquired conditions.

"[The] program builds on the administration's efforts to achieve better patient outcomes while slowing health care cost growth," CMS said in a statement.

Hospital-acquired conditions are a group of reasonably preventable problems, such as bed sores, blood clots and bloodstream and urinary tract infections from catheters, that develop during a hospital stay. CMS said its earlier efforts to reduce such conditions have saved Medicare about $30 million a year.

Medicare, the federal health insurance program for people 65 and older, is often the largest single payer to health care providers, so the decisions CMS makes for it can have enormous market impact.

Hospital-acquired infections often result in costly readmissions. According to CMS, nearly 2 million Medicare beneficiaries are readmitted within 30 days, costing the health care system an additional $17.5 billion.

The penalties announced Thursday, harsher than those of the government's previous similar program, are estimated to total $373 million and fall particularly hard on academic medical centers, roughly half of which nationwide will be punished, according to an analysis by the nonprofit Kaiser Health News.

The penalties come on top of other Medicare-related financial incentives, Kaiser noted. This year, Medicare has already fined 2,600 hospitals for having too many patients return within a month of discharge.

All told, the worst-performing hospitals risk losing more than 5 percent of their regular Medicare reimbursements this year, according to Kaiser.

Representatives of Lehigh Valley Hospital and St. Luke's could not be reached for comment Friday afternoon.

skennedy@mcall.com

610-820-6130

The Pittsburgh Tribune-Review contributed to this report.

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