Tuesday, August 6, 2013

Medicare and Pay for Performance

A recent article from Kaiser Health News discussed hospital penalties for readmission rates (http://www.kaiserhealthnews.org/Stories/2013/August/02/readmission-penalties-medicare-hospitals-year-two.aspx).  Healthcare is extremely complex.  It is tragic that Medicare has to use penalties to facilitate hospitals improving the quality of care.  Hospitals who treated poorer patients had larger penalties. 

The first sentence of the article notes "Medicare will levy $227 million in fines against hospitals in every state but one for the second round of the government’s campaign to reduce the number of patients readmitted within a month, according to federal records released Friday."

A few years ago, I was working on an emergency department project.  In the analysis of data, it was evident that too many patients were returning 4-6 times every month.  At that time, hospitals were only concerned about patient returns within 24 hours.

More patient admissions usually means greater amount of revenue potential.  The same thing is true about medical errors and patient falls.  Use of penalties is unfortunate, but it may be the only way to improve care for now. 

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