Half of Hospitals to Be Punished

 

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The results are in and  “the Federal government will punish more than half of the nation’s hospitals – a total of 2,597 – for excess readmissions by withholding more than half a billion dollars in Medicare payments over the next year.” The new penalties are based on the rehospitalization rate for patients with six common conditions: heart attacks, heart failure, pneumonia, chronic lung disease, hip and knee replacements, coronary artery bypass graft surgery.  I wonder who is going to pay for this?  Do the doctors get penalized?  How about the administrators?  I wish someone actually did a follow up to see what effects these penalties had on the hospital. What do you think?

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  8 comments for “Half of Hospitals to Be Punished

  1. David Grant
    August 14, 2016 at 12:59 pm

    Want to reduce readmissions for heart failure? Implement a “salt gestapo”, which would go to the patient’s houses and confiscate salty foods. I was a hospice medical director for a few years. I first suggested the visiting nurses do just that on home visits. We settled on getting red electrical tape and taping closed everything salty in the refrigerator, pantry, and spice cupboards. At least the patient or family would feel guilty before cheating on the low salt diet. It seemed to work pretty well.
    Hospitals that want to avoid readmissions for heart failure should look for a way to arrange close at-home follow up to see that patients stick (closer) to the diet and medicines that got them better in the hospital.

  2. Bridget Reidy
    August 8, 2016 at 2:07 pm

    We really shouldn’t talk about hospital closures or small practice closures as unintended consequences of various government/insurance/ruler initiatives. As best I can tell they are the intended consequences. Have you ever noticed how they never tell you what problem they are trying to fix when they implement them? That is why you can’t demand evidence that it works beforehand, and it’s very hard to prove they fail afterwards. Fail at what? It’s time we realized lack of access to care is the intent of this whole process, or at least lack of access to a professional that has taken an oath to do no harm and can recognize when a system does, or a hospital that understands the needs of its community and the people working there might actually know the patient and their goals. I wouldn’t be surprised if the next step will be changing medical education or admissions to making sure we get great memorizers of guidelines and scales and put less emphasis on the basic science that allows you to understand how a new drug or process or procedure works and what unintended consequences we may be fixing on our updates in two or ten years. Or could someone more aware of that situation tell me if they’ve already done that.

    • Pat
      August 8, 2016 at 3:25 pm

      Bridget, of course that very indoctrination is already being introduced in med schools and cemented in residency. Just as it was for you and I, the industry welcomes the self-selected who can follow orders – only now those orders are aggressively from the government, and not science-based mentors. I quit training med students because this is such a dishonest industry that I’ll never again encourage anyone into it.

  3. Seneca
    August 8, 2016 at 6:32 am

    Even a government mathematician can figure out that half of hospitals are below the median and close to half are below the mean. If we keep punishing half of the hospitals, we will eventually have very few left–kind of like half life of a drug or radioisotope. At that time we can expect the various busybodies to cry, “What happened?”

  4. Fred powell
    August 7, 2016 at 9:59 am

    I agree, Thomas

  5. Steve O'
    August 7, 2016 at 9:04 am

    And also:
    3) The big corporate and government healthcare institutions need a scapegoat for the decline in healthcare. It’s from industrializing the whole enterprise, but they need to blame it on the doctors and hospitals. The press has been pumping how dangerous hospitals and doctors are. It helps if they can “fail” half of the hospitals caring for patients, and “punish” them. Keeps the heat off the culprits.

  6. William E Green III MD
    August 7, 2016 at 7:48 am

    This is the Obama administration’s goal- to punish hospitals/ providers. They see us as the enemy, and anything they can do to “lower the cost” of healthcare is a “positive outcome”. Even if it means withholding payments due to health care they deem to be “below the standard of care”, increasing the scope of practice of “extenders” (NP, PA, etc.), etc. It’s a brave new world!

  7. Thomas Guastavino
    August 7, 2016 at 7:24 am

    Two great truths:
    1) The government is looking for any excuse for not paying
    2) Hospitals will screen out and avoid treating those patients most in need of care.

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