Will New York City Hospitals That Treat Many Low-Income Patients Face The Heaviest Penalties Under New Federal Reimbursement Policies?

Two new federal policies tying Medicare reimbursements to quality of care took e ect in October 2012. Hospitals are now penalized for excess readmissions. An additional penalty or bonus can be awarded, based on adherence to clinical standards and ratings on patient surveys.

Hospitals that serve the city’s poor−public hospitals and private safety-net hospitals−generally face heavier penalties than other hospitals. Penalties for 8 out of 12 public hospitals and 4 out of 6 safety-net hospitals exceed the citywide average of 0.97 percent of reimbursements.

Medicare accounts for $777 million of expected inpatient revenues in 2013 at Health & Hospitals Corporation facilities, about 30 percent of all anticipated inpatient revenues, ranging from $21 million at North Central Bronx Hospital to $112 million at Bellevue.

Medicare Reimbursement Penalties/Bonuses As a percentage of reimbursements

Other Private Hospital Private Safety-Net Hospital

Public Hospital (HHC or SUNY) Private Academic Medical Center

-2.0 -1.5 -1.0 -0.5 0.0 0.5 -2.0 -1.5 -1.0 -0.5 0.0 Hospital for Special Surgery 0.46% North Central Bronx Hospital -0.49% Staten Island University Hospital 0.23% New York Community Hospital of Brooklyn -0.60% Metropolitan Hospital Center -0.65% Richmond University Medical Center -0.66% Lincoln Medical & Mental Health Center -0.90% Long Island Jewish Medical Center -0.73% Lutheran Medical Center -0.75% New York City Harlem Hospital Center -0.96% Average Lenox Hill Hospital -0.92% -0.97% Kings County Hospital Center -1.03% New York Methodist Hospital -0.93% New York City Kingsbrook Jewish Medical Center Average -0.96% University Hospital of Brooklyn (SUNY Downstate) -1.06% -0.97% Forest Hills Hospital -0.98% Brooklyn Hospital Center at Downtown -0.99% Queens Hospital Center -1.12% New York Hospital Medical Center of Queens -1.13% Bellevue Hospital Center -1.24% St. Luke’s-Roosevelt Hospital -1.15% Beth Israel Medical Center -1.16% Elmhurst Hospital Center -1.29% New York Downtown Hospital -1.36% Jacobi Medical Center Flushing Hospital Medical Center -1.38% -1.41% Woodhull Medical & Maimonidies Medical Center -1.45% Mental Health Center -1.44% New York Westchester Square Medical Center -1.49% St. John’s Episcopal Hospital at South Shore -1.52% Coney Island Hospital -1.53%

-1.5 -1.2 -0.9 -0.6 -0.3 0.0 -1.5 -1.2 -0.9 -0.6 -0.3 0.0

St. Barnabas Hospital -0.50% New York University Hospital Center -0.02%

Brookdale Hospital Medical Center -0.70% New York City Average Mount Sinai Hospital -0.79% -0.97% Bronx-Lebanon Hospital Center -1.08%

Wyco Heights Medical Center -0.87% -1.15% New York-Presbyterian Hospital New York City Average Jamaica Hospital Medical Center -1.23% -0.97% Monteore Medical Center -1.44% Interfaith Medical Center -1.38%

SOURCES: United Hospital Fund; U.S. Centers for Medicare & Medicaid Services NOTES: Some hospitals have more than one campus, but penalties/bonuses are systemwide. Private safety-net hospitals, as dened by the United Hospital Fund (UHF), are those where Medicaid and uninsured patients comprised more than 50 percent of admissions, other than births, in 2008. Prepared by Christina Fiorentini New York City Independent Budget Oce