In the fiscal year 2013 Medicare inpatient prospective payment system (IPPS) final rule, the Centers for Medicare & Medicaid Services finalized which hospitals are subject to the Hospital Readmissions Reduction Program (HRRP), as well as what portion of the IPPS payment will be affected by the readmission adjustment factor. The impact on the diagnosis-related group (DRG) reimbursement will begin October 1, 2012, with the beginning of the federal fiscal year (FY). Studies show nearly one in five patients discharged are readmitted within 30 days, at a cost to the Medicare program of $15 billion per year. Beginning in October, hospitals with readmission rates higher than a certain threshold for the three conditions below will be penalized up to 1 percent of their aggregate base DRG rate. The penalty increases to a maximum of 2 percent in FY 2014 and 3 percent in FY 2015. In addition, the list of conditions measured increases in FY 2015
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Hospital Readmissions Reduction Program to Affect Hospitals Beginning October 1