A Good Goosing

Pretty soon Medicare will reduce payments by up to 1% for more than 2,200 hospitals for excess readmissions in three categories — heart attack, heart failure and pneumonia.  This makes up about two-thirds of U.S. facilities!  They will lose about $300 million next year and maybe more the year after if they don’t improve.   Are most of our hospitals in this country that bad?  No.  This is just an unproven metric that the government is using to save money on healthcare.  My favorite part of this American Medical News article  was Nancy Foster, AHA’s vice president of quality and patient safety policy, who pointed out the following:

  • Hospitals had argued that penalties should be assessed only for aspects they can control.
  • The American Hospital Assn. and the Assn. of American Medical Colleges had asked CMS to consider socioeconomic factors that can lead to patients being readmitted.
  • Facilities had suggested that rates be adjusted to account for numbers of Medicaid beneficiaries as well as for planned or unrelated readmissions.
  • Other factors that need to be considered include patient access to follow-up health care services, such as availability of primary care physicians and ability to afford prescribed medicines.

Why is that interesting to me?  Well, all these points are certainly valid, that’s for sure, but how many of these 2200 hospitals that are getting dinged employ physicians?  I bet most if not all of them.   And how many of these hospitals are using their own unproven quality indicators to grade and penalize their employed physicians in such areas as cholesterol, glycohemoglobins, blood pressures?  Probably most of them.  And their doctors are arguing that these “penalties should be assessed only for aspects they can control”.  And the douchebag hospital administrators ignore them.  Because to them, what is good for the goose is not good for the gander.

20750cookie-checkA Good Goosing