Memorial Hospital One of Nine Wyoming Facilities to Receive Reduced Medicare Payments

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The MHSC Board of Trustees unanimously voted to approve the FY2020 budget at its regular meeting this afternoon.

ROCK SPRINGS — A recent report distributed by Kaiser Health News (KHN) shows that Memorial Hospital of Sweetwater County is one of nine state facilities that will receive reduced payments from the federal government as a result of its readmission rates.

Compiled through the Hospital Readmission Reduction Program (HRRP), MHSC received the notification in August 2018 and KHN recently announced those findings.

While MHSC did receive a payment reduction for readmissions, it did not receive any penalties for “hospital-acquired conditions”, also a part of the HRRP program.

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A readmission occurs when a patient is discharged from Sweetwater Memorial, but then readmitted to the same or another hospital within 30 days.

How the reduction is determined

HRRP calculates the hospital’s excess readmission ratio for six conditions/procedures: Acute myocardial infarction; heart failure; pneumonia; COPD; CABG, a heart surgery not performed at MHSC; and total hip or knee arthroplasty.

That information is then used to determine a payment adjustment. Sweetwater Memorial received the reduction in its inpatient Medicare reimbursements in fiscal year 2019 due to the readmission reduction program results, according to a press release from the hospital.

Care Transition Program

In an effort to lower patient readmission, Sweetwater Memorial has joined 14 other Wyoming hospitals in implementing the Care Transition Program, according to the MHSC release.

“Lowering readmissions is a complex group effort that we can’t credit to one thing, nor could we blame one thing when it is high,” said Patty O’Lexey, Care Transition Nurse. “It’s not about the readmissions, it is about the patients and their families. That is why we have decreased readmissions, we focus on the patients.”

Ranked second lowest on the list of readmission payment reductions, MHSC received a 0.07 percent reduction of inpatient Medicare reimbursements for fiscal year 2019. It is the smallest reduction of payments the hospital has received in the past five years for readmissions.

“We are proud that the changes we have made are reflected in our decreased readmission rates, and ultimately better patient outcomes,” said Kara Jackson, MHSC Quality Director.

The KHN Report

The Kaiser report can be found at khn.org or the Hospital Compare Program at medicare.gov/hospitalcompare.

Aspen Mountain Medical Center also appeared on the KHN report, however officials question being listed since they do not receive Medicare or Medicaid reimbursement.

KHN is a nonprofit news service committed to in-depth coverage of health care policy and politics. In addition to its website, Kaiser’s stories are published by news organizations throughout the country.