San Diego Hospitals Getting Lower Medicare Payments Under ACA

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Under a provision in the Affordable Care Act, eight San Diego County hospitals are receiving lower Medicare payments for having too many patient readmissions, U-T San Diego reports.

About the Penalties

Under ACA's readmission reduction program, a hospital can lose up to 1% of its annual Medicare reimbursement if its rate of readmission is deemed too high. That penalty is expected to increase over the next two years.

The penalties took effect for the first time this fall.

Details of Penalties in San Diego County

Hospitals in San Diego County that are receiving lower payments include:

  • Alvarado Hospital, which is receiving a 0.02% payment reduction;
  • Grossmont Hospital, which is receiving a 0.38% payment reduction;
  • Paradise Valley, which is receiving a 0.09% payment reduction;
  • Scripps Memorial Encinitas, which is receiving a 0.02% payment reduction;
  • Scripps Mercy Hospital, which is receiving a 0.13% payment reduction;
  • Sharp Coronado Hospital, which is receiving a 0.07% payment reduction;
  • Sharp Memorial Hospital, which is receiving a 0.41% payment reduction; and
  • UC-San Diego Medical Center, which is receiving a 0.21% payment reduction.

Hospitals Respond

James LaBelle -- chief medical officer for Scripps Health -- said that some people disagree with how the government adjusts for the severity of patients' illnesses when considering readmissions.

However, he said that he believes all hospitals can and should boost efforts to reduce readmissions.

Daniel Gross -- executive vice president for hospital operations at Sharp HealthCare -- said Sharp is working with patients after their discharge to ensure that they schedule follow-up appointments and follow care instructions (Sisson, U-T San Diego, 11/1).

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