Medicare’s Quality Transparency Effort Ineffective
Medicare’s seven-year public reporting initiative for hospitals, Hospital Compare, had no impact on reducing death rates for two key health conditions and just a modest effect on a third…
The study, published in the March issue of Health Affairs, showed that Hospital Compare produced no reductions beyond the existing trends in improvement of care of heart attacks and pneumonia… The researchers found a modest improvement in mortality rates for heart failure, though they can’t prove that this was related to the public reporting initiative.
Not surprising.
No surprise for me here.
I can’t remember the last time I read a Medicare-related article that had good news.
The medical entitlement programs seem to be remarkably effective at convincing the public that they’re on the path to improvement when subsequent results tell us they’re far from it. Yet, disappointing internal results never yield effective external reforms. I guess that’s just not the MO of Washington. #LobbyistLove
That’s not surprising. Hospitals aren’t competing for patients on the basis of price. When they don’t compete on price, they don’t compete on quality either.
Ultimately, what many hospitals end up competing on is how much they can get in insurance reimbursements.
The downside is that hospitals ignored quality treatment approaches to other disease states, inasmuch as they attended to diktats out of Washington in order to keep JCAHO accreditation, and, I would guess, quality of care overall declined. The initiative may well have cost lives and money. I have spent the last several years trying to get the hospital where I worked focused on inpatient diabetes care, which is abysmal at the hospital, with no success, indeed, my efforts, in the end, got me fired, for criticizing the hospital administration too vehemently. Inasmuch as Washington didn’t dictate any quality measures on diabetes, the hospital had no interest in diabetes care, in fact, gutted resources for any effort to improve quality of diabetes care. while there were charts galore in the doctor’s lounge touting statistics on pneumonia and heart attacks, patients languished with very poor DM control in the hospital. Poor inpatient diabetes care translates in to worse outcomes, longer stays, more costs, more complications, and higher mortality rates. Washington is killing patients, with the complicity of healthcare facilities. Jefferson predicted such, when he said: Were we directed from Washington when to sow and when to reap, we should soon want bread.
Today he would have said: Were we directed from Washington for our medical care, we should soon be sicker or dead.