A new study in JAMA Cardiology found that “as many as 10,000 heart failure patients could die prematurely each year because of misguided efforts that keep them out of the hospital to avoid the financial penalties attached to higher readmissions.” This comes as no surprise to ANY of us who actually do the real work in healthcare. We have been saying this for years but it never mattered to the insurers, the government or the administrators. Once again, quality metrics fail. In this study, people died but the hospital doesn’t care because they didn’t lose Medicare money. It’s gross. Here is the beautiful part: nothing will change until Medicare changes the penalty even though the hospitals now know it is WORSE for patients. That’s the beauty of unproven metrics. It changes behavior for the wrong reasons and that behavior won’t change back until the incentive changes.
This is actually a great test. How many hospitals, who claim they are patient-centered, will change their policy before the government does? Those that don’t (which I expect to be 100%) will prove that really they are just money-centered.