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CVS to expand program aimed at reducing hospital readmissions for Medicare members
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104.1 KSGF
By Amina NiasseNEW YORK (Reuters) -CVS Health’s Aetna insurance arm will expand a nascent program pairing members in its privately run Medicare plans with nurses – an effort the company says will reduce hospital readmissions, which are costly and can be detrimental to patient health.
CVS’s move comes after the Centers for Medicare & Medicaid Services in July finalized a rule that includes Medicare Advantage members in calculations for readmission penalties applied to hospitals, effective in the fiscal year 2027.
The American Hospital Association has protested that this inclusion would wrongfully penalize hospitals for negative outcomes associated with coverage delays and denials.
The government insurance agency recalculates performance each year and flags hospitals with higher-than-expected readmissions over 30 days for some conditions, before reducing payments by up to 3% of discharge fees paid.
A spokesperson for CVS Health said the program is meant to improve patient health, which would benefit Aetna and providers, adding the company will push for similar programs moving forward.
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