Contained within the health care reform legislation are several programs to reduce costs via various initiatives from Accountable Care Organizations and quality initiative partnerships to simply cutting payments to hospitals. All these programs are focused on Medicare with the hope, if successful, some will be extended throughout the health care system. The problem is that no one knows for sure if the programs will be successful or what the unintended consequences may be.
CMSs recently announced cuts in payments to hospitals for Medicare patients is drawing flack from the hospitals who claim payments are already below costs while CMS claims hospitals were overpaid in the past.
Are there sufficient opportunities for hospitals to be more efficient and thus absorb payment cuts with no adverse result? I’m not sure anyone knows. It is possible hospitals will seek offsetting revenue and that could mean cost shifting to the non-Medicare population.
There is no argument when it comes to raising quality standards, reducing risks to patients or pushing for more efficiency. However, these efforts must be mutually achieved by providers and payers otherwise little will be accomplished for the overall health care system regardless of the impact on Medicare costs.
We need true incentives for all parties to make this work system wide. Where is the patient in this equation? The inherent value to patients should be obvious, and patients need to be fully aware of these initiatives understand and support them. However, past experience tells us that is not always the case.
We will here cries of government intervention in our healthcare and there is much of that. However, we must also ask if not government, who will address these issues?
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