The Substantial Financial Cost of PAMA Penalties

Cost of pama on Skilled Nursing Facilities

The Substantial Financial Cost of PAMA Penalties

The cost savings are obvious. Having all-hours access to a skilled specialist through TeleHealth Solution saves a hospitalist program nearly 67% of the average nocturnal rate—and changes the way medicine saves lives. This is the future of healthcare.

The average cost of each readmission: $10,352

Total cost per year in the industry of all readmissions: $4.34 BILLION

78% of readmissions were avoidable visits to a major medical facility

The annual industry cost for avoidable hospital stays: $3.39 billion
(Costs will increase after penalties are applied)

The SNF 30-Day All Cause Readmission measure is potentially very costly to SNFS.

The financial penalties from CMS will likely be similar to those faced by acute care hospitals with higher than average 30-day readmission rates: up to 3% of Medicare reimbursements. The SNF data will be risk-adjusted. (Details about the risk adjustment calculation will likely be released in early 2018.)

At least some patients will be excluded from the measure, including:

  • Residents who are transferred to an inpatient rehabilitation facility
  • Residents who are transferred to a long-term acute-care facility
  • Residents who are discharged directly to home
  • Planned readmissions that happen within the 30-day period
  • Residents who leave the SNF against medical advice
  • Patients with specific DRGs (principally cancer and cancer-related diagnoses)
  • Patients who are readmitted for observation only. Information Sourced from
  • HealthStream.com Post Dated February 24, 2016
  • “There is evidence that virtual encounters can reduce the number of ED visits. That saves money for payers and can also enhance the bottom line of healthcare organizations that are at risk for the cost of care,” says Joseph Kvedar, MD, vice president of connected health at Partners Healthcare in Boston, in Medical Economics.
  • 93% of consumers using TeleMedicine reported a lower healthcare cost–Becker’s Review

With the TeleHospitalist on call, protocols in place, and cart integrated into your EMR, you’ll feel like you have the physician in house—but at a substantial savings.

2017-05-11T02:58:07+00:00

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