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Louisville Hospitals Facing Medicare Payment Penalty

Published on Jan 3, 2019 at 8:37 am in Medical Malpractice.

All acute-care hospital in Louisville, Kentucky and those in Floyd and Clark counties in Indiana will see reduced Medicare payments during the federal fiscal 2019.

The reductions are happening because the hospitals did not meet the performance standards established by the Centers for Medicare & Medicaid Services’ (CMS) Hospital Value-Based Purchasing Program (VBP).

The VBP Program was implemented in 2012. It is designed to make the quality of care better for hospital patients and make hospital stays a better experience for patients. This program reduces all Medicare payments to participating hospitals by two percent and that money then gets redistributed to hospitals depending on their performance in a number of areas:

  • Mortality and complications
  • Healthcare-associated infections
  • Patient safety
  • Patient experience
  • Process
  • Efficiency and cost reduction


To promote improvements in those areas, they encourage hospitals to eliminate or reduce adverse events like healthcare errors that result in patient harm, adopt evidence-based care standards and protocols that make the best outcomes for most patients, change hospital process to make patients’ care experiences better, increase care transparency for consumers, and recognize hospitals that provide high-quality care at a lower cost to Medicare.

Hospitals earn scores on two scales – one for achievement and one for improvement. The final score awarded is the higher of the two and is adjusted by how well the individual hospitals perform compared to all the facilities and how much their performance improved compared to the performance prior to the baseline.

Hospitals who excel performance-wise may receive a maximum bonus of 3.67 percent. Poor performing hospitals may face a maximum reduction of 1.59 percent.

The reductions in Louisville are slightly higher than the national averages, which is around 0.39 percent. The following hospitals are receiving a reduction between 0.02 and 1.10 percent, depending on how poorly they performed:

  • Baptist Health Floyd, New Albany, Indiana – 0.02 percent
  • Clark Memorial Hospital, Jeffersonville, Indiana – 0.75 percent
  • Jewish Hospital & St. Mary’s Healthcare, Louisville – 0.39 percent
  • Baptists Health Louisville, Louisville – 0.52 percent
  • Norton Hospital / Norton Healthcare Pavilion, Louisville, 0.44 percent
  • Kentuckiana Medical Center, Clarksville, Indiana – 1.10 percent
  • University of Louisville Hospital, Louisville, 0.97 percent

The list above does not include the individual hospitals in Jefferson County that are owned by Louisville-based Norton Healthcare Inc. because CMS groups those hospitals together.

The reduction will end on September 30, 2019.

 

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Tad Thomas has dedicated his practice to representing plaintiffs in various types of civil litigation, including personal injury, business litigation, class actions, and multi-district litigation.

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