Heart failure is a chronic condition associated with high morbidity and mortality and a significant economic burden in the United States. As the most common admitting diagnosis in Medicare patients, the greatest portion of this economic burden stems from the care delivered during hospitalization. In 2013, the Centers for Medicare and Medicaid Services implemented a maximum 1% financial reimbursement penalty for acute care facilities with excessive readmission rates for heart failure, pneumonia, and acute myocardial infarction. Of importance, these penalties apply to all Medicare readmissions, not just the chronic conditions mentioned. Now in its third year with maximum penalties increased to 3% and expansion of the program to include chronic obstructive pulmonary disease and hip or knee replacements, a total of 2610 or 78% of all hospitals are being penalized for excessive readmissions, for an estimated total of $428 million.3...

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