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Sunday, September 30, 2012

Medicare Fines Over Hospitals' Readmitted Patients

If you or an elderly relative have been hospitalized recently and noticed extra attention when the time came to be discharged, there's more to it than good customer service.

As of Monday, Medicare will start fining hospitals that have too many patients readmitted within 30 days of discharge due to complications. The penalties are part of a broader push under President Barack Obama's health care law to improve quality while also trying to save taxpayers money.

About two-thirds of the hospitals serving Medicare patients, or some 2,200 facilities, will be hit with penalties averaging around $125,000 per facility this coming year, according to government estimates.

Data to assess the penalties have been collected and crunched, and Medicare has shared the results with individual hospitals. Medicare plans to post details online later in October, and people can look up how their community hospitals performed by using the agency's "Hospital Compare" website.



Steven Rumney said...

This is an interesting development. Health care is one of the few professions where compensation is not based on results(Politics does also comes to mind). Health care provider compensation is based on procedural code or "face time" (such as an office visit)not on results. Good diagnosis and effective treatment or bad diagnosis and improper treatment they are all billable events to the patient (or government). The bill is expected to be paid whether the patient's health improves or not. At my company I have seen numerous employee garnishments to collect payment for medical treatments that actually made the patient worse! Most people are not sensitive to the total lack of accountability in our health care system.

A recent report by the Institute of Medicine estimated that one-third of all health care dollars are wasted; a staggering $750 billion per year! They list unnecessary services, inefficient delivery, administrative costs and fraud as big problems. I think their dollar figure is low if you add in poor treatment and misdiagnosis which is very common, particularly around here.

This new Medicare initiative may not be perfect and you can expect push back from the apologists at the AMA and the American Hospital Association but anything that adds accountability to health care sounds like a good thing to me!

Anonymous said...

They need to start with all the doctors who outright use Medicare patients as ATM's!
THIS, in my opinion is what has contributed the most to skyrocketing healthcare costs, not the uninsured, who don't go to the doctor until absolutely necessary!
I watched as doctors in Salisbury did this ATM/like BS with my mother in law. She'd go to see her regular doctor for her "checkup" and then end up being sent to at least 2 more for unnecessary tests, then they all wanted to put her on medications she did not need. Some of them actually counteracted another of the meds she was on so it was a vicious cycle!
My husband and I broke the cycle with hers but there are many more elderly out there that nobody has a clue about.
If you have an elderly parent, research what drugs they're taking and get rid of those which duplicate or counteract another drug, or, that they just downright don't need to be taking!
You'll save them a small fortune, especially if they're in the donut hole!!!

Anonymous said...

Sometimes the patient's outcome is not the fault of the doctor or hospital. When they get sent home with instructions or prescriptions, sometimes those instructions are not followed correctly by the patient. Or they don't get their medicine or take it properly. Some of this has to be self responsibility. There are plenty of non-compliant patients out there.

Steven Rumney said...

Anonymous 11:51

This was very well said. Many health care providers DO see their patients as cash cows. Health care is an unusual business. Health care providers almost never involve patients in a discussion of price. In no other industry would we consider providing our contractor a blank check to perform any test, conduct any procedure or prescribe any medicine they choose and agree to pay no matter what the outcome. However that is exactly how it is done in health care everyday. It is always best when patients (or their family members) get actively involved in their treatment plan. You did the right thing by helping your mother-in-law. More people need to become active like this. Job well done!