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How The Health Law Is Using Medicare To Improve Hospital Quality


Among the tools: penalties for admitting patients too soon after they were discharged and a focus on reducing hospital-acquired infections. KHN’s Mary Agnes Carey and Jordan Rau discuss:

MARY AGNES CAREY: Welcome to Enrollment Encore: What you need to know before open enrollment in the health law’s marketplaces begins again on November 15th. I’m Mary Agnes Carey.

Jordan Rau, who is a senior correspondent with Kaiser Health News joins me now to talk about how the health law is using Medicare to improve health care quality. Jordan you’ve written a lot about how hospitals have been the focus on this, let’s talk first about the effort to avoid readmissions to hospitals.

JORDAN RAU: This is the third year that hospitals face a possibility of losing money from Medicare payments because they have too many patients return within 30 days of readmission. So there is a lot more focus within these hospitals to make sure that when the patients leave, when they’re discharged, that they don’t just go out and if they don’t have doctors or don’t have any medical oversight that their health deteriorates. So it’s likely that some of the hospitals that are putting the most effort into this will be sending nurses to the homes of patients, to go through the medications, make sure they’re taking the right things, check on their health. And the hospitals, about two-thirds of them are being penalized from this, this year so it’s a high priority.

MARY AGNES CAREY: There’s also a focus to reduce hospital-acquired infections. What’s happening there?

JORDAN RAU: This is the first year that a quarter of the nation’s hospitals are going to lose 1 percent of their Medicare payments because too many of their patients contracted infections. Now there are six type of infections Medicare is looking at including infections that occur during hysterectomies and colon surgeries, as well as two very, very nasty antibiotic resistant bugs, MRSA and C. diff. So hospitals are going to be – for some of these they have some pretty good ideas about how to avoid them and for others it’s a real struggle, but hospitals will be putting a lot more attention on these measures and on avoiding infections.

MARY AGNES CAREY: And there’s also an effort to improve patient satisfaction.

JORDAN RAU: Right this is the third year that hospitals can get a bonus or lose money based in part on how well they score on these surveys that are sent to patients after they leave. These surveys ask questions like: Did your doctor communicate well? Did the nurse communicate well? Was your pain handled well? And so a lot of hospitals have gone to the extent of giving scripts to doctors and nurses to communicate better.

MARY AGNES CAREY: Thank you so much, Jordan Rau with Kaiser Health News.

This article was produced by Kaiser Health News with support from The SCAN Foundation.

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Health Industry Medicare The Health Law