No Hospital Left Behind !

August 17, 2012
175 Views


Is health care going to follow along the failed path of Education in the United States?


Is health care going to follow along the failed path of Education in the United States?

More than 2,000 hospitals — including some nationally recognized ones — will be penalized by the government starting in October becal use many of their patients are readmitted soon after discharge, new records show.
Together, these hospitals will forfeit about $280 million in Medicare funds over the next year as the government begins a wide-ranging push to start paying health care providers based on the quality of care they provide. One proposed measure is the rate of readmission.
With nearly one in five Medicare patients returning to the hospital within a month of discharge, the government considers readmissions a prime symptom of an overly expensive and uncoordinated health system.
Nearly 2 million Medicare beneficiaries are readmitted within 30 days of release each year, costing Medicare $17.5 billion in additional hospital bills. The national average readmission rate has remained steady at slightly above 19 percent for several years, even as many hospitals have worked harder to lower theirs.
These results reported by The Happy Hospitalist who also blogs and specializes in ‘in patient hospital medicine”.The report is in Kaiser Health News.
The penalties, authorized by the 2010 health care law, are part of a multipronged effort by Medicare to use its financial muscle to force improvements in hospital quality. In a few months, hospitals also will be penalized or rewarded based on how well they adhere to basic standards of care and how patients rated their experiences. Overall, Medicare has decided to penalize around two-thirds of the hospitals whose readmission rates it evaluated, the records show.
Kaiser Health News analysis of the records shows.  Hospitals that treat the most low-income patients will be hit particularly hard.
A total of 278 hospitals nationally will lose the maximum amount allowed under the health care law: 1 percent of their base Medicare reimbursements. Several of those are top-ranked institutions, including Hackensack University Medical Center in New Jersey, North Shore University Hospital in Manhasset, N.Y. and Beth Israel Deaconess Medical Center in Boston, a teaching hospital of Harvard Medical School
Most of these teaching hospitals treat  r uninsured patients on Medi-caid programs or other public safety net systems. Outpatient services are often very restricted, or unfunded. The patients have an increased rate of chronic illness which are more advanced in the first place since these patients do not get admitted until their disease is well advanced. Their care must be maximized prior to discharge, since their support  system is fragile or even not existent. This requires longer hospital stays, (which offsets the reduced re- admission rate)
 
“A lot of places have put in a lot of work and not seen improvement,” said Dr. Kenneth Sands, senior vice president for quality at Beth Israel. “It is not completely understood what goes into an institution having a high readmission rate and what goes into improving” it.
Sands noted that Beth Israel, like several other hospitals with high readmission rates, also has unusually low mortality rates for its patients, which he says may reflect that the hospital does a good job at swiftly getting ailing patients back and preventing deaths.
Data for readmission rates are available in PDF or CSV files.
Atul Grover, chief public policy officer for the Association of American Medical Colleges, called Medicare’s new penalties “a total disregard for underserved patients and the hospitals that care for them.” Blair Childs, an executive at the Premier healthcare alliance of hospitals, said: “It’s really ironic that you penalize the hospitals that need the funds to manage a particularly difficult population.”
Does this sound familiar….??
Perhaps a wiser more prudent decision would be to implement this as a pilot program with regional distribution accordingly.