Let's quit rewarding hospitals for mistakes
The Kansas City Star
As polarized as we are over health care and how to pay for it, I’m pretty sure we can agree that hospitals should not be rewarded financially for bungling surgeries.
But it happens, according to a study published Tuesday in The Journal of the American Medical Association.
Researchers studied records of 34,256 patients who had surgery in a Texas hospital, and found that 1,820 surgeries resulted in preventable complications, like pneumonia and infections.
Those complications resulted in longer hospital stays and more procedures, driving up hospital revenues an average of $30,500 for each botched surgery, with private insurers paying much higher costs than Medicare or Medicaid.
The study’s authors say clearly that no one is deliberately messing up surgeries in a quest for higher profits. On the other hand, the perverse incentives don’t exactly motivate hospitals to be extra careful. It’s a glaring example of the main problem with health care financing. Mistakes and excessive care are rewarded, while there’s no real motivation to practice quality medicine. The Affordable Care Act is packed with provisions attempting to reverse the incentives, and some hospitals and doctors’ groups are beginning to put them in place — in some cases at the insistence of large employers. This latest study should provide additional cause for insurers to back off on payments for substandard care. The study’s authors further recommend that excellent care should be rewarded with bonuses.
Another excellent recommendation: Require hospitals to disclose their complication rates. Absolutely, let’s put the market to work. Patients will be much more likely to avoid hospitals with high complication rates, especially if word gets out that the institutions are profiting from the mistakes.
Here is an abstract of the study. You need a password to get into the actual article.