According to a report in MedCityNews.com, a startup company named Health Recovery Solutions has created an online tool that calculates the Medicare penalty for every U.S. hospital. Available at healthrecoverysolutions.com/resources.php, the calculation is based on publicly available Medicare data for readmission rates, Diagnosis-Related Group reimbursement data and the published formula for how to calculate what a penalty will be. The company said it had to include additional analysis to account for expected Medicare reimbursement and case count growth rates. DRG reimbursement rates, for example, vary by socio-economic region.
The calculation considers the three diagnoses set forth by the Affordable Care Act, Heart Failure, AMI and Pneumonia. Bonus payments and additional penalties from the Value-Based Purchasing program (hospitals rewarded or penalized for patient outcomes) are added to or subtracted from readmission penalties to arrive at a net penalty amount.
Health Recovery Solutions is a member of New York-based Blueprint Health accelerator's current class of healthcare startups.
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