Ilovebenefits’s Blog

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Health Care Quality is Not Without Cost

Editor’s note: The current reimbursement system rewards more services. It doesn’t reward doing the right thing.

Doctor’s and hospitals, in an archaic way, are paid to make mistakes.

Now if you bought a toaster at Wal-Mart and it burnt the toast the first ten times you used it, you would bring it back. Wal-Mart would either issue you a full refund or replace the toaster without additional cost.

On the otherhand, if you cut your knee and require stitches at the local ER you pay (dearly) for the use of the ER. If you go home and the next day you there is an infection at the site of the stitches you go back to the hospital they ‘fix’ it and you pay again.

So here is a story of Medicare changing the reimbursement, getting a better result and the hospital losing money because of better care.


“Quality is not without cost,” said Michael Goler, chief medical officer at the Cleveland County HealthCare System, whose hospital in Shelby, N.C., is a top performer in the Medicare project. “People are doing this because they feel this is the right thing to do, but they are doing that despite the economic burdens.”

The hospital, for example, hired 1 1/2 full-time-equivalent nurses to track quality data and also bought new beds that helped reduce infections. Its success in keeping heart-failure patients from returning to the hospital—readmission rates dropped 37% over three years—actually cost the hospital money because fewer admissions meant less reimbursement from Medicare, hospital officials said.

Read the rest of the story here:


August 17, 2009 - Posted by | Economics of Health care, healthcare, quality | , , ,

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