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 AHCA Calls For Broader Readmission Standards

​Congress should broaden categories of readmissions before penalizing skilled nursing centers for unnecessarily sending patients back to the hospital, the American Health Care Association (AHCA) says.

In a letter to the House Ways & Means Committee, AHCA President and Chief Executive Officer Mark Parkinson says he supports efforts to reduce rehospitalizations, but he’s worried by current language in a House bill that focuses efforts on specific conditions or diseases.

“Any measure that is disease- or condition-specific, or not all-cause, creates challenges to assure accurate coding,” Parkinson says in the letter, dated Aug. 30. “In addition, measures which are condition-specific or limited to ‘potentially preventable conditions’ lower the potential savings, since the population being evaluated is much smaller.”

Parkinson also says he’s concerned about the way penalties would be levied against long term care centers. Unlike hospitals—which face a steady progression of increasing penalties for every year they can’t cut down on preventable readmissions—skilled nursing centers would be looking at a 3 percent penalty from day one, Parkinson says.

Second, Parkinson adds, the current legislation doesn’t set a definite period for readmissions to count toward a penalty. Hospitals are penalized for readmissions within 30 days of discharge, but the current bill would leave skilled nursing centers’ clock up to the Department of Health and Human Services, Parkinson says.

Parkinson says he would like to see a readmissions initiative that moves away from a “penalty-only” program. “Even providers with very low readmission rates who see small increases in those rates due to statistical variations may pay a penalty despite still maintaining lower-than-average rates,” he says.

Elsewhere in his letter to Ways & Means, Parkinson says he and his association:
• Support a “site-neutral” payment system;
• Back the Obama administration’s efforts to restore the “75 percent rule,” which would require that so-called inpatient rehabilitation facilities prove that at least 75 percent of their patients have a qualifying condition before they’re reimbursed;
• Support “the analysis and evaluation” of bundled payment systems, but
• Oppose “any national, mandatory program until such an evaluation can be completed;” and
• Would fight “any arbitrary, sequester-like cuts to provider rates that do nothing but stifle innovation and threaten beneficiary access to quality care.”

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