Posted by: AtlasMD

November 26, 2013

Medicare Penalizes Nearly 1,500 Hospitals For Poor Quality Scores

As you know, the health law’s insurance markets are struggling. Oh well, that hasn’t stopped the Obama administration from moving ahead with its second year of “meting out bonuses and penalties to hospitals based on the quality of their care,” says NPR.

And this year, it looks like more hospitals lost than won.

So how does this bureaucratic mousetrap work? The government determines if hospitals get more or less Medicare dollars for the work they complete based on patients’ surveys. And what were this year’s results? According to NPR, “Medicare has raised payment rates to 1,231 hospitals based on two-dozen quality measurements, including surveys of patient satisfaction and — for the first time — death rates. Another 1,451 hospitals are being paid less for each Medicare patient they treat for the year that began Oct. 1.”

NPR says half the hospitals will see negligible changes while others are going to see a noticeable difference.

Still, though, the logic here is pretty absurd. These “bonuses and penalties” are part of our nation’s healthcare reform to create financial incentives for doctors and hospitals to provide better care. “This program is driving what we want in health care,” said Dr. Patrick Conway, Medicare’s chief medical officer. Wait, so what do you want in healthcare, Dr. Conway? To us, it looks more like paperwork and mind-numbing questionnaires, not actual improvements. Has anyone been to the DMV lately? Be honest. Did you have an efficient experience?

And here’s where things start to get a bit more fishy. NPR says,

“Under the program, called Hospital Value-Based Purchasing, Medicare reduced payment rates to all hospitals by 1.25 percent. It set the money aside in a $1.1 billion pot for incentives. While every hospital is getting something back, more than half are not recouping the 1.25 payment they initially forfeited, making them net losers.”

Okay, let’s be clear here. Our government took a huge chunk of money, and made a game that hospitals have to play in order to “win back” the tax dollars set aside for Medicare payouts. And then when hospitals collectively didn’t meet the criteria, the government just kept that money. As if we don’t already have overworked doctors who are struggling to get paid on time. This is enough to make us livid. THE GOVERNMENT IS GETTING OVERALL DISAPPOINTING HEALTHCARE RESULTS FROM PEOPLE WHO NOW HAVE TO DO EXTRA WORK TO CONVINCE THE GOVERNMENT THEY DID GOOD WORK.

You might have to read that sentence a second time. And that’s okay. Because that sentence makes no sense. However, that’s what our government is doing to address poor healthcare results. I don’t know about you but maybe the government should just incentivize actual doctors and nurses to get work done. Maybe give direct care practitioners a one-year tax break to help them get their business off the ground. Anything but this type of incentivized nonsense. Seriously, have these people ever used a “Meaningfully Useful” EMR before?

Exactly. We didn’t think so. Oh and get this, next year there will be even more money at stake. NPR explains,

“Medicare is planning to add new measures next year, including comparisons of how much patients cost Medicare at different hospitals and rates of medical mishaps and infections from catheters.”

Excellent. And in 2015, the health law will roll out a quality payment program for physician groups of 100 professionals or more, and oh yeah, this will be expanded to all doctors by 2017 (we are looking into whether direct care is affected or not). And why would anyone do something like this? NPR says, “The goal of all these programs is to replace the current financial incentive in Medicare, in which the only way for a hospital to get paid more is to perform more procedures and take on more patients.”

Touche. At least the government admits that it’s a problem. Now whether this payment program works or not? I’m sure we’ll get back to you with real results in 8 or 9 years.