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Hospitals penalized for emergency room visits

By Megan Brantley, mbrantley@wcyb.com
Published On: Oct 01 2012 04:43:23 PM CDT
Updated On: Oct 01 2012 04:21:48 PM CDT

Medicare is buckling down on hospitals to keep their patients from being readmitted.

JOHNSON CITY. Tenn. -

Hospitals are given a gauge for readmissions and if they go above the given amount, they will be penalized.

So for large medical groups like Mountain States, it was important for them to figure out a quick solution.

Sometimes the emergency room is your only option. "There are times when you can’t get in to see your physician and there may be an emergency that you feel you need to go to the emergency room, you don't have a choice," said Alma Wheeler.

News 5 learned over two thousand hospitals will be hit with fines starting this week if Medicare patients are readmitted to the hospital within 30 days of being checked out.

Ed Stump, the Assistant Vice President of Cardiology Operations, says that the fines are to help move hospitals in the right direction. "It's an attempt to help drive care from more of a procedural care to more of a focus on wellness and a preventative care," said Stump.

Stump tells us that they have known about this change for a few years and planned for it with the Congestive Heart Failure Clinic. It is for patients with CHF. "[We] offer a service to those higher risk type patients that are out there to come in and be seen free of charge with a nurse in the clinic," said Stump.

He says 30 percent of the readmissions are from CHF, making it the number one problem.

We learned that the main goal of the clinic is actually to educate people and they are hoping that by giving them this information it will help lower the number of readmission into the hospital.

Patients will be able to gain help with finding medication, learn about better eating habits and gain a better understanding of what their health condition is.

Mountain States says they are already seeing progress. "We're starting to see some of those favorable outcomes. I just looked at our readmission from last month and they were significantly impacted on a lower level," said Stump.

The penalties are part of President Obama's health care law to improve patient care and decrease the cost to the taxpayers.

The penalties will be averaging around $125,000 per hospital; that is about two-thirds of the hospitals that help Medicare patients.

Representatives from Mountain States said that because of the amount of hospitals in their company, they could be forking out up to seven figures.