‘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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