Save the Date: WSHA webcast on new Medicaid readmissions policy on November 28 at noon

Since August, WSHA has actively engaged with the state Health Care Authority (HCA) on a new policy that will replace the existing payment penalty for hospital with higher than average readmissions. WSHA will be sending out the final policy with connection information for the webcast to hospital leaders in the next couple of days. The new policy, effective January 1, 2018, places much more emphasis on the hospital’s role in discharging patients to prevent potentially preventable readmissions.    The new policy will allow a managed care organization and HCA, for fee-for service enrollees, to recoup payment for a readmission if the hospital is found to have not followed its duties outlined in the policy. MCOs and HCA must also be able to show that the hospital’s error caused the patient to be readmitted. Through WSHA’s advocacy, the policy excludes certain categories of diagnoses that have high rates of readmissions due to external factors outside the control of the hospital and includes several other protections for hospitals. The new policy also does not apply to critical access hospitals. (Chelene Whiteaker, chelenew@wsha.org )