As part of Obamacare efforts to control costs the Department of HHS has a program to “reward” hospitals based on certain quality measures and patient evaluations. HHS withholds 1% of a hospitals payment which it can then earn back in full or part based on their results. Frankly, I am not a fan of incentive programs of any kind that reward people or doing their job. In this case, the measures are quite fundamental and what you would expect from your hospital following standard medical protocol. Interestingly, some of the biggest, most well known hospitals did not earn back their full 1% while some very small instituitiins did muh better. Here is more information on the program.
The way the program works is that Medicare is reducing payments to all hospitals by 1%, estimated at $964 million. It then calculated a score on how much money each hospital deserved to get back based on the quality of its care. While every hospital is getting something back, almost half aren’t recouping the 1% they forfeited and thus are net losers.
Seventy percent of the scores are based on how frequently hospitals followed 12 basic clinical standards of care, such as controlling heart surgery patients’ blood sugar levels and giving them beta-blockers to lower their blood pressure. The other 30% is determined by how well hospitals were rated by former patients in surveys asking about the communication and responsiveness of doctors and nurses and the cleanliness and quietness of their environment.
Visit the HHS website where you can see and compare the results of the quality measures. Put in several of your area hospitals and judge for yourself the quality and relevance of the data, the data that is available or missing and why.
Do you agree hospitals should be paid for following standard medical procedures or what in some cases is self reported information?
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