Final answer:
Medicare and Medicaid can respond to hospitals with high readmission rates by reducing reimbursements, following regulations set by the Affordable Care Act, which seeks to shift healthcare from being volume-driven to value-driven.
Step-by-step explanation:
Medicare and Medicaid can penalize hospitals with high readmission rates by reducing reimbursements, which is a measure designed to incentivize improvements in hospital care quality and patient outcomes. The Patient Protection and Affordable Care Act (ACA or Obamacare) provided the regulatory framework for such actions, emphasizing the shift from volume-driven to value-driven healthcare.
With the enactment of the ACA, hospitals are financially encouraged to reduce unnecessary readmissions. They are expected to ensure better post-discharge planning and follow-up care, improve communication with patients about their treatment and management at home, and coordinate with other healthcare providers in the community. These measures help to control healthcare costs and ensure that patients receive appropriate care without the need for rehospitalization.
Overall, the intent of these penalties is to balance the economic scales of healthcare provision, ensuring that all patients, regardless of socioeconomic status, have access to quality care without the undue burden of repeated hospital visits. It is also aimed to address the moral hazard and adverse selection issues that were exacerbated by the fee-for-service system that did not adequately regulate healthcare provisions or costs prior to the ACA.