Why This Newsletter
According to preliminary data from the Center for Medicare and Medicaid Services (CMS), the number of hospitals expected to face CMS readmission penalties for FY 2025 may drop for the third straight year.
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CMS’s Hospital Readmissions Reduction Program may include 100 fewer hospitals in FY 2025 (Oct. 1, 2024- Sept. 30, 2025) than the program did in FY 2021 (Oct. 1, 2020-Sept. 30, 2021). This reduction is significant because it could mark the lowest number of hospitals penalized under the readmission program in five years.
The hospital readmission performance FY 2025 period uses a rolling three-year period of historical claims data from July 2020- June 2023. Based on the claims data, CMS expects 7% of hospitals will be charged a penalty, reducing each penalized hospital Medicare fee-for-service reimbursements by 1%. In addition, 71.6% of hospitals will be charged a penalty of less than 1% based on their readmissions history and 21.4% of hospitals will not see any penalties at all.
CMS will release its final FY 2025 Hospital Readmission Data in October 2024.
For additional information about the CMS Hospital Readmission Program click here https://rowinskigroup.com/key-reimbursement-stakeholders-resources . Scroll down to USA Federal Government Agencies Coding Organizations and open the Centers for Medicare and Medicaid Services portal.
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About Rowinski Group
Founded in 2004, Rowinski Group LLC is a reimbursement and healthcare payer data analytics consultancy for medical device, digital health and diagnostics companies who are developing and selling their medical technology in the USA. Rowinski Group has offices in Silicon Valley – San Francisco Bay area and Chicago, Minneapolis, and Raleigh.
Rowinski Group has two core service offerings; securing codes and reimbursement on behalf of companies and applying healthcare payer data analytics to help companies solve business issues such as responding to questions from the FDA and Medicare, sales forecasting, Key Opinion Leader (KOL) identification etc.
Through these service offerings Rowinski Group help U.S. and international companies build their U.S. market share for the medical technology they are developing and selling. For more information visit https://reimbursement.consulting or contact Daniel Zimmerman d.zimmerman@reimbursement.consulting.
