Free Republic
Browse · Search
News/Activism
Topics · Post Article

Skip to comments.

Unintended consequences: CMS program might be harming patients
Modern Healthcare ^ | 11-26-2017 | Maria Castellucci

Posted on 11/27/2017 5:35:55 PM PST by spintreebob

The CMS' Hospital Readmissions Reduction Program was an expensive wake-up call. Hospital leaders needed to prevent patients from making a U-turn after discharged. The hospital was hit with a $397,153 penalty.

The penalty program established under the Affordable Care Act has motivated hospitals to change care practices. Readmissions have fallen as hospitals respond to penalties that can dock up to 3% of their Medicare payments. (excerpts from article.)

But the tactics hospitals have adopted to avoid a penalty might not always be in the best interest of patients. As hospitals reduced readmissions for heart failure mortality rates increased.

Financial incentives from the readmissions program can influence hospital behavior, and not always for the better.

"The big penalty has meant hospitals put less attention on reducing complications and reducing mortality."

The CMS' own math has placed a higher value on reducing readmissions than improving mortality rates. Under the Hospital Value-Based Purchasing program, high mortality numbers cost a hospital 0.2% of its Medicare payments, compared with a 3% readmissions penalty.

The CMS said it "monitors the impact of our programs"

Given the challenges of caring for heart failure patients, it's plausible that tactics hospitals adopt to avoid readmissions have a negative impact on patients' survival rates, said Jason Hockenberry, Emory U.

"We still don't understand what these incentives are doing to care processes, and how they might be impacting patients," he said. "Are they satisfied with their care? That is unclear at this point."

The CMS also adopted the program across all acute-care hospitals without much insight or evidence into how it will impact hospitals. "We have no idea whether reducing readmissions is going to have an impact on health outcomes," Hockenberry said.

There are unintended consequences...

(Excerpt) Read more at modernhealthcare.com ...


TOPICS: Business/Economy; Culture/Society; Government; News/Current Events
KEYWORDS: aca; healthcare; navigators; obamacare
HHS/CMS is the customer. CMS decides what to buy and pay for... What is a billable event and what is a penalty event.

The patient is just a widget in the CMS process. The patient is not the customer. The CMS process is not designed to help the patient. The hospital response is designed to be paid and to avoid being hassled by CMS.

1 posted on 11/27/2017 5:35:55 PM PST by spintreebob
[ Post Reply | Private Reply | View Replies]

To: spintreebob; All
"The CMS process is not designed
to help the patient...."




Help FR Continue the Conservative Fight!
Your Monthly and Quarterly Donations
Help Keep FR In the Battle!

Sponsoring FReepers are contributing
$10 Each time a New Monthly Donor signs up!
Get more bang for your FR buck!
Click Here To Sign Up Now!


2 posted on 11/27/2017 5:42:17 PM PST by musicman (The future is just a collection of successive nows.)
[ Post Reply | Private Reply | To 1 | View Replies]

To: spintreebob

So healthcare decisions made by bureaucrats don’t always turn out well for the patient.

Who would have ever seen that one coming?


3 posted on 11/27/2017 5:44:40 PM PST by exDemMom (Current visual of the hole the US continues to dig itself into: http://www.usdebtclock.org/)
[ Post Reply | Private Reply | To 1 | View Replies]

To: spintreebob

It’s simple. Patients who are dead don’t cost the government valuable money that can be used to buy votes.


4 posted on 11/27/2017 5:45:58 PM PST by txrefugee
[ Post Reply | Private Reply | To 1 | View Replies]

To: musicman

My wife just had a procedure that required an overnight stay in the hospital. When she was released she had to sign a document that acknowledged she had not been actually admitted to the hospital. So they are learning to get around this.


5 posted on 11/27/2017 5:56:27 PM PST by SubMareener (Save us from Quarterly Freepathons! Become a MONTHLY DONOR)
[ Post Reply | Private Reply | To 2 | View Replies]

To: SubMareener

LOL, so it was the “bed and breakfast” wing of the hotel ?


6 posted on 11/27/2017 5:59:19 PM PST by onona
[ Post Reply | Private Reply | To 5 | View Replies]

To: txrefugee

Bingo!


7 posted on 11/27/2017 6:08:17 PM PST by faithhopecharity (“Politicians aren’t born, they’re excreted.” - Marcus Tillius Cicero (3 BCE))
[ Post Reply | Private Reply | To 4 | View Replies]

To: spintreebob; All
There was a Wall Street Journal article a couple days ago on this: ObamaCare’s Death Payments: A program to reduce hospital admissions may have led to more deaths. The headline reads "may have led to more deaths," but the data in the article are quite conclusive that the "Hospital Readmissions Reduction Program" is needlessly killing 5,400 Americans per year to save some pennies.

And the libs said "You stupid conservatives -- there ARE NO Death Panels in Obamacare."

8 posted on 11/27/2017 6:27:57 PM PST by ProtectOurFreedom
[ Post Reply | Private Reply | To 1 | View Replies]

To: SubMareener

it’s called over night observation, hospitals get paid at a different rate of outpatient observation then inpatient stays.


9 posted on 11/27/2017 7:02:51 PM PST by markman46 (engage brain before using keyboard!!!at)
[ Post Reply | Private Reply | To 5 | View Replies]

To: spintreebob

Government regulations destroyed Medicare long ago


10 posted on 11/27/2017 8:15:10 PM PST by Nifster (I see puppy dogs in the clouds)
[ Post Reply | Private Reply | To 1 | View Replies]

Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.

Free Republic
Browse · Search
News/Activism
Topics · Post Article

FreeRepublic, LLC, PO BOX 9771, FRESNO, CA 93794
FreeRepublic.com is powered by software copyright 2000-2008 John Robinson