Chicago-Area Hospitals Fined for Readmissions

Chicago-Area Hospitals Fined for Readmissions | Pintas & Mullins Law Firm

Four years ago, Medicare started penalizing hospitals for patients that returned within a month of discharge, also known as readmissions. The Hospital Readmissions Reduction Program is meant to encourage hospitals to consider how patients fare after they leave the hospital. Our team of medical malpractice lawyers examines the Illinois hospitals facing the most penalties for readmissions.

The more Medicare patient are readmitted, the more the hospital is penalized by receiving lower Medicare reimbursements for each patient, whether they are readmitted or not. In Illinois, 113 hospitals will receive lower Medicare reimbursements starting in October, accounting for 62% of the state’s hospitals.

Presence Saint Joseph Medical Center in Joliet will have its reimbursements reduced by 2.79%, the highest in the Chicago area. The average reduction rate throughout the state is 0.72%, which is still worth millions of dollars. Nationwide more than 2,500 hospitals will lose an estimated $420 million in Medicare reimbursements.

Illinois has the eighth-highest average penalty rate among all states. The fines are based on Medicare patients who were originally hospitalized for one of five conditions:

  1. Heart attack
  2. Pneumonia
  3. Elective hip or knee replacements
  4. Heart failure
  5. Chronic lung conditions

Illinois Valley Community Hospital had the highest jump in readmissions among the state’s hospitals. The hospital told the Chicago Tribune that it serves mostly elderly patients with serious conditions, a demographic that often requires readmissions despite a hospital’s best efforts. Illinois Valley has taken several measures to reduce readmissions, such as establishing a transitional care program and hiring nurses exclusively to help discharged patients.

The top ten Chicago-area hospitals facing the largest penalties can be found here, on the Tribune’s website. Of course, readmissions are just one factor in a hospitals’ overall quality.

Yelp for Doctors

On the online reviewing website Yelp, doctors, lab testing companies, dentists, nursing homes and other healthcare practitioners are rated like restaurants. Patient reviews often focus on non-medical issues, such as billing ease, staff friendliness, and wait times.

Reviews have gotten so popular that Yelp and ProPublica recently teamed up to publish ProPublica’s statistical information on Yelp’s pages. ProPublica is a highly esteemed non-profit organization that gathers objective data, publishes investigative journalism pieces, and has been awarded a Pulitzer Prize.

In their new partnership, ProPublica’s interactive health databases will appear on the Yelp pages for health providers. Yelp users will not only see consumer reviews, but will also be able to view data about how the provider compares to its peers. Consumers will be able to see penalties waged against nursing homes, deficiencies at health clinics, ER waiting times, and quality of services in dialysis centers, among other information.

Consumers on Yelp tend to rate health providers similarly to how they would rate any other business. They are likely to talk about how easy or difficult it is to make an appointment, staff professionalism, billing errors, and how they felt they were treated overall.

The medical malpractice lawyers at Pintas & Mullins Law Firm encourage patients to do all the research they can before agreeing to any type of medical treatment, drug, device or procedure. It is your right to know all the risks and benefits of the services you are receiving. If you or someone you love was seriously injured or killed due to medical negligence or malpractice, contact our firm immediately for a free consultation.