Medicare will fine you, but still reimburse you.

One of the questions I am frequently asked is: Will the hospital treating a patient re-admitted within the last 30 days still be reimbursed?  The answer is yes.  A practical argument becomes: Why prevent a $15,000 re-admission to avoid, at most, a 3% penalty?  Food for thought isn’t it?  Of course, the 3% maximum penalty applies to all Medicare reimbursements and not just the DRG of the re-admission, but somewhere in there is a delicate balancing act.  After all, nearly one in five Medicare patients is re-admitted within 30 days.  The idealist in me leaps up and claims that there is a moral obligation to deliver the type of care, coordination, and tools necessary to prevent re-admission and continued suffering.  But then, there is the dark realism that for some of our small hospitals not having revenue from re-admission might mean having to close the doors.  That would clearly be worse for the patients and the communities they passionately care for.  Does anyone have any good ideas?