At the end of a decade of federal oversight of hospital readmissions, Medicare is levying penalties on  nearly half the nation’s hospitals in the form of reduced payments due to excessive revisits.

The average penalty is a .64 percent reduction per Medicare patient stay from October 2021 through September 2022, according to a recent analysis in Kaiser Health News. Those fines can add up significantly — they averaged $217,000 per hospital in 2018, according to a congressional commission.

The maximum penalty, 3 percent, was imposed on 39 hospitals, while 547 hospitals saw so few readmissions that they received no penalty. Payments were reduced to 2,499 hospitals, 47 percent of all U.S. facilities.

Many hospitals are exempt because they specialize in children, psychiatric patients, or veterans. Rehabilitation and long-term care hospitals also are excluded.

Reducing readmission rates is a national priority for payers, providers and policymakers seeking to improve healthcare while reducing costs. The Hospital Readmissions Reduction Program was created in 2010 as part of the Affordable Care Act.

An abstract recently submitted and presented at the CHEST 2021 annual meeting found that hospitals that perform bronchoscopies can reduce readmission rates by more than half, and potentially lower costs, by adopting single-use flexible bronchoscopes.

That study — by Dr. Hudson Garrett, an infection prevention specialist and an Ambu consultant — looked at the health outcomes of 14,228 patients who underwent a bronchoscopy and found that single-use bronchoscopes reduced the readmissions rate 53 percent, from 7.7 percent to 3.6 percent, compared with reusables.

His study followed a safety communication update from the U.S. Food and Drug Administration on reprocessing flexible bronchoscopes. The agency recommends that healthcare providers consider single-use bronchoscopes when there is increased risk of infection and when treating COVID-19 patients.