Posted on 06/06/2016 5:38:50 PM PDT by spintreebob
We conclude that (hospital) CEOs are heavily driven to perform on government pay for performance metrics, but less so to metrics that currently fail to correspond to a reimbursement requirement. (Conclusion first here)
Truven Health Analytics™ and Mercer teamed to investigate whether there is a correlation between CEO compensation and hospital performance on a balanced scorecard. The study showed there is a strong alignment for the highest level of performance. However, the study also found that 80% of hospitals do not perform well on a balanced scorecard. Instead, compensation appears to be designed to incent the CEO to pursue metrics mandated by CMS – leading to potentially dangerous imbalances in performance.
This study examines the association between tax-exempt hospital CEO compensation and a vetted national balanced scorecard composite score representing hospital-wide key performance indicators. The study further examines the association between CEO compensation and the individual key performance indicators comprising the national balanced scorecard.
(Excerpt) Read more at truvenhealth.com ...
Check this quote from Health Language a different industry rent seeker. Where is the patient?
"Patient information is scattered across provider offices, labs, hospitals, and insurers—and that information is valuable to provider decision-making and quality reporting."
http://blog.healthlanguage.com/mips-raises-the-stakes-on-clinical-documentation-and-quality-reporting?utm_source=hs_email&utm_medium=email&utm_content=30192089&_hsenc=p2ANqtz-_6_vDgtDZ7oTTeNbEuuCTSg9BMWHwNU4lhDUpzXuge2Zj9EFMMc56pggYEPhOINNHdhfK14zbxhz5_sEu2-1O5jwQBHQ&_hsmi=30192089
The patient is a widget to the industry. Everyone collects and stores in the HIE database information about the widget. But the widget who knows the most about himself has no input into the database.
Now what could go wrong with this direction for Central Planning of Healthcare?
Healthcare is no different from any other endeavor.
You can get it fast.
You can get it good.
You can get it cheap.
Pick any two.
Cost is high and the quality shytty.
Forecast calls for higher costs and even shyttier quality in the foreseeable future.
Your information is now a commodity to be bought and sold.
You no longer have any control of where that information goes, or to whom , or for what purpose.
HIPPA annimosity is dead !
and everything that government touches , turns to crap !..eventually !
Having centralized medical records hasn’t been the case because the infrastructure and database management were not there. That no longer being the case, it’s time for the medical industry to come into the twenty-first century.
Each time I go to a new doctor, it’s ridiculous to have to start all over from scratch.
My theory is that people in the Healthcare Indusry are personally and collectively motivated to do what is in their financial self-interest.
Their money overwhelmingly comes from CMS. All private healthcare insurance is regulated by CMS and obeys the CMS rules. Of course, many of the insurance companies also get their money from CMS.
All healthcare technology is designed to get the money either directly from CMS... or controlled by CMS regulations.
Our healthcare system is not designed to meet the needs or wants of the patient.... the widget.
Why do you have to start from scratch? Don’t you know your own health history? You cannot discuss your history to the new physician?Dont you think that you have a responsibility to know your health history and relay it to your new physician? It is, after all, your health.
My theory is that people in the Healthcare Indusry are personally and collectively motivated to do what is in their financial self-interest.
Their money overwhelmingly comes from CMS. All private healthcare insurance is regulated by CMS and obeys the CMS rules. Of course, many of the insurance companies also get their money from CMS.
All healthcare technology is designed to get the money either directly from CMS... or controlled by CMS regulations.
Our healthcare system is not designed to meet the needs or wants of the patient.... the widget.
It’s also my information, for which I paid. If it’s not going to be portable, it should be available for use elsewhere.
And when you get to be as old as I am, remembering the timeline for a fifty year medical history isn’t likely.
No one is going to look at your history from 50 years ago, it is mostly irrelevant. If patients paid for the huge cost of software or chart storage, then you have the right to own your chart. But since you do not cover the cost, and Medicare pays very little to the physician- then the best thing to do is know your own health history and not rely on the healthcare system to hold your hand.
So you’re saying between my copay and the insurance payout, the expenses involved in producing my medical records are not fully covered. How do they stay in business then? Do they make up for it in volume?
Look at your bill. Medicare pays approx 30-50 dollars for a visit. My yard man gets more money than that.You are not paying the hundreds of thousands of dollars that is the cost of computer medical records to install and maintain. You are actually lucky to have a physician if you are on Medicare, because it is charity care.
Hospitals and other medical offices were required to implement Electronic Medical Records. Just another step toward Fedzilla being able to acquire info they have no business knowing.
I suspect a patient that dies waiting for a decision delayed by the metrics doesn’t count against them, in fact it improves their score.
That's because the system, as designed , isn't for your benefit, nor your doctor; it is designed for .gov computers.
It is designed to place you and your medical condition, affix a number so that government can claim accountability and responsibility..
and yet government does neither !
Neither does it keep the costs down.
“Requiring even a small amount of consumer initiative can dramatically reduce participation levels in benefit programs. One example is provided by the difference in SNAP participation levels when H&R Block tax preparers actually filed SNAP forms on families’ behalf, compared to when they handed families completed forms and told them where to submit these forms. Integration initiatives—indeed, enrollment efforts of all kinds—are likely to increase their effectiveness to the extent that they can eliminate the need for their intended beneficiaries to take action before receiving aid.”
https://aspe.hhs.gov/sites/default/files/pdf/139271/rpt_IntegrationFinalRpt.pdf
So the eggheads at HHS know what is best for those not signed up for ACA and want navigators to unilaterally sign up those who don’t do it on their own. Again, the patient, the consumer is not in the decision making process at all. From one end to the other, the government knows what is best.
One reason for this is that Hispanics, especially those of Mexican heritage and not taking the initiative to sign up despite pressure from all directions. A high percentage of them have low incomes and hence qualify for subsidies, Medicaid, etc. But they are the most “underserved” of all demographic groups. This is totally frustrating the central planners who know it is in the best interest of those Hispanics to sign up and exercise their “rights”.
“incentives for hospitals to skimp on care and Medicaid patients have no say in any of it.”
http://www.michigancapitolconfidential.com/22472
The government plans and regulations incentivize providers to go for the government money... regardless of what the patient wants or what the doctor thinks is best for the patient. So many doctors and most institutions go for the money dangled in front of them by CMS (Medicare & Medicaid).
incentives for hospitals to skimp on care and Medicaid patients have no say in any of it.
http://www.michigancapitolconfidential.com/22472
So the government incentivizes what it wants the doctors and hospitals to do. Patients/consumers are not in the process, except as widgets to go through the system. Some Doctors defy the government incentives. But many doctors and most hospitals and institutions go for the money dangled in front of them by the government.
Same old playbook. Johnson’s “Great Society” initiative to eliminate poverty - had government employees scouring the hills of SW Mo. (other states too) for any one who might be able to sign up for freebies.
Yes it sucks big time. However, I have a general medical Dr. that I see in my small rural town. When I have to see a specialist, such as a cardiologist, he sends a report to my Dr.
In addition, I get copies of any and all tests, lab results, medical reports etc. I keep these in a 3 ring binder along with my family history and current medicines. I also take a bullet point list of what I want to talk to the Dr. about, and check them off and make notes.
After the visit, I take a few minutes at home to add details to the notes, and file in the binder. I learned the importance of doing this, after my Dad had a stroke and moved in with me. He was on more than 20 meds. and had 5 specialists. The info was invaluable several times at the ER. So I also do the same for my husband, though he is extremely healthy.
Current Government initiatives are to improve “quality” of care and emphasis on prevention. The result has been that more time is spent asking the patient questions that the Government wants. Go in for the flu-they’ll have to ask you about your last colonoscopy, mammogram etc.
Economic reality is that the Dr. has to see enough patients to pay his own salary, that of all the personnel, supporting him, and the other costs of business. Roughly 22 patients or more per day, depending on the expenses - some areas are more costly to do business than others.
Fortunately, my doctor is an older one, who still believes in patient care, and is amiable enough to go along with a patient’s ideas about what they need. I do a lot of on line research, and have some Professional Dr. Deskguides that I read some too. That’s so that I know what questions to ask, and what their answers mean. Started doing that back when my Dad arrived to recuperate.
The government crap is only rivaled by the Insurance crap. One Insurance Company around here was known as “God Help the Patient”. Especially bad were HMOs. Medicare patients actually have some special protections enacted by Congress.
The hospital has to let you know about those, and one is that they can not discharge you, if you feel it is premature. Since the Medicare payment amount is often less than the actual time you need, hospitals will try to rush this as a stop loss measure.
ACA IIRC, now charges a penalty, if readmission happens within a certain time - 3 days IIRC. The whole system is a nightmare.
Some Docs are getting smart, and opting out of Ins. all together. You pay cash. You worry about reimbursement from whoever.
As the baby boomers get older, what should be a “growth industry” has been turned into a government cost burden for taxpayers. For anyone whose company has an HSA, or any company who is still offering traditional policies, at least look at the HSA with the high deductibles.
Both of my daughters did the Math at their various companies. The HSA is best for Employees and Employer. Most people don’t really understand the HSA well enough to know that.
Many years ago, when I first started working, the company did not have health ins. I paid my own bills. If I had a hospital bill, that was too large, I made payment arrangements. The HSA also puts the patient back into the loop - they decide how to spend the dollars along with their Dr. It’s a better alternative. JMHO
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