‘Center of Excellence’ Designation May Not Mean Fewer Deaths, Readmissions or Even Excellence

It’s time to expose the insurance companies and their lowlife plans. We all know how their rates keep going up, which parallels their profits and stock prices. They were terrible before the ACA but somehow got much worse after the ACA. Now there is this:

Several health insurance plans have created Centers of Excellence (COE) programs to identify hospitals that deliver high quality care. A growing number of American patients find that health plans are trying to limit their choice of hospitals and doctors to Centers of Excellence, but whether steering patients to these particular hospitals leads to better outcomes hasn’t been clear.

For the current study, researchers examined data on rates of 30-day mortality and readmission, or repeat hospitalization, at 62 hospitals in New York State, focusing on patients who had a heart attack or procedures to restore blood flow to the heart. This included five hospitals with a COE designation from Aetna, nine with a COE designation from Cigna, and 17 with a COE designation from Blue Cross Blue Shield (BCBS). 

Hospitals with Aetna’s COE designation had a higher average 30-day mortality rate than other hospitals, with 1.4 versus 1.1 fatalities for every 100 so-called percutaneous coronary intervention (PCI) procedures to restore blood flow to the heart. 

There wasn’t a meaningful difference in PCI mortality rates with COE designations from Cigna or BCBS. And, none of the three COE programs appeared to make a meaningful difference in mortality rates for heart attacks.

So, why would they deem these places “excellent”. I’ll let Dr. Dr. Deepak Bhatt explain:

“Insurers likely make these determinations primarily based on cost to them,” Bhatt, who wasn’t involved in the study, said by email. “Patients should not assume that these designations reflect actual quality or outcomes.”

There you have it. The insurance companies did the same thing they did with drugs. They made back room deals to steer people to medications from companies that gave them the cheapest price. It had nothing to do with efficacy. It has to do with profit and greed. Now they are doing the same thing with hospitals. So what should we call these places? Here are my thoughts:

  • Centers of Greed
  • Centers of Mediocrity
  • Centers of Bullshit
  • Centers of Places Were We Make the Most Money

Please add you own.

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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] 

  1 comment for “‘Center of Excellence’ Designation May Not Mean Fewer Deaths, Readmissions or Even Excellence

  1. Steve O'
    May 28, 2019 at 9:52 pm

    The fantasy world we all live in is that there is no truth, merely competing narratives. Are the Centers for Excellence truly Centers for Excellence? In the last century, such a question could be addressed and logically answered.
    Now, the answer is yes, and no. There exists two narratives, one that the term is phoney, and the other is that the term is legit. As they are both narratives, they are both valid.
    It is possible to determine the truth in certain circumstances, but people will advocate for both sides, and who is to say that THEIR truth is not the true truth?

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