Question

A local news organization has published a story about the readmission rates for hospital in their area. The news organization determined from the data that two local hospitals will be receiving reduced reimbursement from CMS because their readmission rates fall outside of the accepted range. Upon contacting a spokesperson from each hospital, the new organization received the following responses to their inquiry:

Middling Medical Center: “These readmission rates were based on outdated data reported several years ago. This data does not accurately reflect the care that we provide to our patients. We have made numerous changes to our processes in the past several years and this is not reflected in this data. We are not concerned by these results and believe we continue to delivery high quality care.”

Quality Hospital : “We have proactively conducted our own analysis of this data prior to the CMS report and determined that our area of concern is confined to one service line. In response to our analysis, we have implemented a hotline for patients discharge from this service line to call with any questions after discharge. This call center is staffed by service line nurses that have access to the patients discharge instructions and providers if necessary. We feel this is important data that we must take seriously to keep our quality of care at the level that our patients expect.”
Discuss the differences in responses by the two hospitals and the CMS readmissions programs.

What do you think about the responses from these two hospitals?

Answer 1

The differences in between the two hospital are at Middling Medical Center, they blamed the technology that it didn't show the updated information .The data provided is outdated and they are providing quality service only.Whereas the Quality hospital ,They conducted an internal analysis found a fault and tried to improve quality by implementing the hotline system to patients. The CMS readmission program has found there is some lack of professional work to keep up the quality as a result which has led to high readmission rate.

The response from Middling Medical Center shows negligence which can be considered to be a malpractice in patient care to provide quality care and the Quality hospital instead of clearly describing the discharge details to patient at the time of discharge can be one of reason to increased readmission rate.