Medicare penalizes 10 Wyoming hospitals

By Seth Klamann

Casper Star-Tribune

Via Wyoming News Exchange

CASPER — The federal government has penalized nine Wyoming hospitals for high readmission rates, and another one for high levels of hospital-acquired medical conditions, a report from Kaiser Health News shows. 

The hospitals listed in the report were each docked a certain percentage of the funding they receive from Medicare. According to Kaiser Health News, the Affordable Care Act allows Medicare to cut payments from the program as penalties. 

Overall, according to Kaiser — one of the leading health outlets in the nation — a total of 800 hospitals were penalized across the country. Ten were in Wyoming. 

The penalties are percent of payments from Medicare to the facilities. A cap of 3 percent is applied to readmission rate penalties, and hospitals are docked 1 percent for hospital-acquired conditions. 

The hospitals penalized in Wyoming for excessive readmission rates are: 

St. Johns Medical Center in Jackson, penalized 2.82 percent; 

Mountain View Regional in Casper, penalized 1.54 percent;

Cheyenne Regional, penalized 1.26 percent; 

Wyoming Medical Center, 1.12 percent; 

Campbell County Memorial Hospital, 0.63 percent; 

Evanston Regional, 0.36 percent; 

SageWest Health Care in Riverton, 0.32 percent;

Sweetwater County; 0.07 percent;  

Ivinson Memorial Hospital in Laramie, 0.03 percent. 

St. Johns’ 2.82 percent penalty is the highest of any Wyoming hospital since the penalties began in 2015. 

Meanwhile, Rock Springs’ Aspen Mountain Medical Center was the only hospital here penalized for hospital-acquired conditions in 2019. 

Four Wyoming hospitals were penalized for high readmission rates for the fifth straight year, Kaiser’s analysis found. They are Cheyenne Regional, Wyoming Medical Center, Campbell County Memorial and Evanston Regional. Wyoming Medical is the largest hospital in the state, while Cheyenne Regional is the second-largest. 

Wyoming Medical acquired Casper’s Mountain View in April 2018. Mountain View faced the second-highest readmission penalty in the state, at 1.54 percent. 

WMC has never been penalized by the government for hospital-acquired conditions, according to Kaiser’s analysis, while Mountain View was docked for it in 2015 and 2016. 

Hospitals have broadly been critical of Medicare’s penalty system. The American Hospital Association called it “a game of chance for many hospitals, rather than a fair and meaningful determination of their performance” in an article from last year. According to the association, nearly 60 percent of the hospitals penalized for hospital-acquired conditions were not statistically different from those hospitals who were under the threshold for a penalty. 

But Kaiser quoted an official from Leapfrog — a hospital quality watchdog — who said that the ratings were important to improve quality. 

Leapfrog gives hospitals a safety grade each year. It gave WMC a C in fall 2018, for instance, though the hospital wasn’t penalized by Medicare for hospital-acquired conditions. Nor was Jackson’s St. Johns, which received an A grade. 

Mirroring arguments in favor of the Medicare penalties, supporters of Leapfrog say it’s an important piece in a broader effort to improve hospital quality. Leapfrog is also aimed at allowing health care consumers to shop and compare facilities.

Emailed requests for comment were not returned Wednesday from the Wyoming Hospital Association and from the Wyoming Business Coalition on Health, advocates for Leapfrog and broader efforts to improve hospital quality and price transparency.

Banner-Community Hospital in Torrington was not included on the list of penalized hospitals.