Penalizing Everything We Like
The problem:
One in five Medicare patients, for example, returns to the hospital within 30 days. Over all, readmissions cost the federal government an estimated $17 billion a year.
One hospital's solution:
Nicollet Health Services, a hospital and clinic system based in St. Louis Park, Minn. started tackling the readmission problem four years ago, spending as much as $750,000 annually on more nurses and on sophisticated software to track heart failure patients after they left the hospital. It reduced readmissions for such patients to only 1 in 25, down from nearly 1 in 6…… The effort saved Medicare roughly $5 million a year.
Medicare's response:
As part of a Medicare experiment to reduce readmissions, Park Nicollet earned a bonus of $247,000 in 2008 – but that payment equaled only about a third of the cost of running the program that year.
The hospital's response:
Park Nicollet, which a few years ago had 640 patients enrolled in the program, has reduced enrollment to 380 – the patients at highest risk of being readmitted.
This is why we are unlikely to get the efficiencies that Obama keeps talking about until we first reform Medicare.
At least Medicare is consistent. High qualilty, low cost care is penalized almost everywhere.