Skip to content

Return to the Full Article View You can republish this story for free. Click the "Copy HTML" button below. Questions? Get more details.

Medicare Scales Back Rule On Hospitals With Pricey Patients

Medicare today scaled back its proposal to hold hospitals accountable for the cost of patient care in the 90 days after discharge. Medicare announced in its final rule that hospital payment would be reduced if the hospital’s average patient had a higher than normal cost to Medicare during their stay until 30 days after discharge — two months less than it had originally proposed.

The change was not unexpected. In fact when it proposed the rule in May, Medicare invited arguments that the period should be one month, not three months. Hospitals had strongly argued against the scope of the “Medicare spending per beneficiary” measure.

Still, it’s unlikely the scaled-back version will placate hospitals that don’t think it’s fair to be judged on the cost patients run up once they’ve walked out the door. KHN wrote about that broad concern in a story over the weekend.Medicare does not appear to have changed its new program to punish hospitals with higher-than-expected readmission rates, which was the focus of that story. But a fact sheet accompanying the release said Medicare may make changes to that rule down the road.

In its final rule, Medicare said it will eventually lengthen the period that hospitals will be judged on their average patient’s spending. But Medicare said it will wait until hospitals get used to the initial 30-day period.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

Some elements may be removed from this article due to republishing restrictions. If you have questions about available photos or other content, please contact khnweb@kff.org.