Community Hospitals and Wellness Centers in Bryan is one of 12 area hospitals slated to receive lower Medicare payments in 2020 due to two separate Affordable Care Act pay-for-performance programs.
The two pay-for-performance programs can issue penalties to medical institutions for higher rates of infections, patient injuries and failure to keep readmissions below the ACA benchmark.
CHWC is one of nine area hospitals that will have Medicare payments reduced by up to 3 percent this year under the Hospital Readmissions Reduction Program (HRRP). While 3 percent is the maximum reduction, the actual percentage is often much lower, according to data from the Centers for Medicare and Medicaid Services (CMS).
Along with CHWC, area hospitals affected by the HRRP include Mercy Health Defiance Hospital, Blanchard Valley Hospital in Findlay, Mercy Health St. Vincent Medical Center in Toledo, Tiffin Hospital, St. Luke’s Hospital in Maumee, Mercy Health St. Anne Hospital in Toledo, Mercy Health St. Charles Hospital in Oregon and ProMedica Flower Hospital in Sylvania.
Chad Tinkel, CHWC president/CEO, said Friday that while Medicare can reduce a payment up to 3 percent per patient for a readmission, CHWC’s averages are much lower. He cited readmission statistics posted on Kaiser Health News showing CHWC’s penalty at 0.57 in 2015, the first year the program under the ACA. It was 0.77 in 2016; 0.01 in 2017; 0.06 in 2018; 0.07 in 2019; and 0.06 in 2020.
Tinkel estimated the average annual cost to CHWC’s bottom line at about $4,000 a year as a result of the reduction in payments penalties, adding, “$4,000 over a year does not impact the level of care we provide.”
Requests for comment on behalf of Mercy Health Defiance Hospital from Maureen Richmond, director of public relations for MercyHealth, were not returned.
CHWC is not on the list of 786 hospitals that will receive lower payments in 2020 as part of a second program — the ACA’s Hospital-Acquired Condition Reduction Program. The HACRP is an incentive-based initiative to inspire better care at hospitals that have the highest rates of in-house infections and patient injuries.
That HACRP list includes three area hospitals: the University of Toledo Medical Center, Wood County Hospital in Bowling Green and ProMedica Bay Park Hospital in Oregon. Each will have Medicare payments reduced by 1 percent for one year, according to the CMS.