Tuesday, September 18, 2012

 Hospitals: Stop Trying to Reduce 30 Day Readmissions
Don’t be afraid to say something’s silly.
September 18, 2012 – Back on August 9, I wrote a blog “A Silly Medicare Policy: Penalizing Hospitals for 30 Day Readmissions.”  I said  hospitals should not be held  responsible and penalized  for 30 day readmissions in Medicare patients.   Elderly patients’ frailty and their chronic diseases, I argued, are responsible.   I felt a little guilty about calling the Medicare establishment “silly.”
But now Westby G. Fisher, MD,  a board certified internist, cardiologist and cardiac electrophysiologist practicing at NorthShore University HealthSystem in Evanston, IL., joins me in use of the world “silly” when speaking of penalties for 30 days readmissions.
Doctor Fisher says:
“Call me silly, but my bet is that hospitals would do WAY better off financially in the long run if they stopped trying so hard to follow unproven legislative initiatives.”
His reasoning why the penalities are silly after the first round of Medicare pay cuts goes like this:
(1) The vast majority of Illinois hospitals were penalized (112 of 128) (Could that many hospitals be wrong?)
(2) Heart failure, heart attack, and pneumonia patients were targeted first because they are viewed as “obvious.”(“Obvious for what?)
(3) “A lot of places have put a lot of work and not seen improvement,” said Dr. Kenneth Sands, senior vice president for quality at Beth Israel.( When that many hospitals try and fail, something is  fundamentally wrong with the proposition that hospitals are at fault)
(4) Even the nation’s #1 Best Hospital (according to US News and World Report) lost out. ( Even the very best can’t measure up to impossible to meet standards)
“So what’s a hospital to do?”
“I have a suggestion based on other observations in regard to government-imposed pay-for-performance measures that have cost hospitals and clinics across the land untold billions to implement and still have failed to demonstrate even a break-even financial proposition for hospitals.”
“Stop trying.”
Tweet:  When 90% of hospitals are penalized for not meeting 30 day re-admission standards,  maybe the standards can’t be met and should be dropped

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