I read yesterday that a number of physicians are ditching private practice in favor of working for hospitals, and turning into Democrats in the process. I wonder what they’ll think when they find out Medicare, under a Democrat administration, wants to punish hospitals if patient care costs too much, even if the care occurs after patients leave the hospital.
For the first time in its history, Medicare will soon track spending on millions of individual beneficiaries, reward hospitals that hold down costs and penalize those whose patients prove most expensive.
The administration plans to establish “Medicare spending per beneficiary” as a new measure of hospital performance, just like the mortality rate for heart attack patients and the infection rate for surgery patients.
Hospitals could be held accountable not only for the cost of the care they provide, but also for the cost of services performed by doctors and other health care providers in the 90 days after a Medicare patient leaves the hospital.
This plan has drawn fire from hospitals, which say they have little control over services provided after a patient’s discharge — and, in many cases, do not even know about them. More generally, they are apprehensive about Medicare’s plans to reward and penalize hospitals based on untested measures of efficiency that include spending per beneficiary.
Update: Senator Chuck Schumer talked about this on one of the Sunday shows. CNS News explained:
Sen. Charles Schumer (D.-N.Y.), appearing on NBC’s “Meet the Press” today, proposed a reform that would ration health care for sick seniors by telling doctors the Medicare system would pay them a single flat fee for treating a particular illness as opposed to paying for the specific services needed to treat a particular patient.
The system proposed by Schumer would give health-care providers a financial incentive to withhold care from sick seniors because each and every service or treatment they provided would cut into their profit margin–or cause them to lose money.Under the current fee-for-service Medicare system, Medicare payments are already so low that many doctors do no take new Medicare patients because it costs them too much to do so, or they transfer the costs of treating Medicare patients to private insurance holders by charging higher rates to them.
Yet Schumer sees greedy doctors as Medicare’s root financial problem.
Via Anthony Martin on the Examiner.
Tags: Chuck Schumer, cost, Democrats, doctors, hospitals, Medicare, punished, rationing, treatment
There are ways to monitor the type of services the patients receive after they have left the hospital. What this article fails to state is this is nothing new as the current reimbursement system monitors patients currently and any patient receiving care after discharge related to the Diagnosis Related Grouping that the hospital receives is reduced from the hospitals reimbursement. For instance, a patient is hospitalized and is then discharged to a Skilled Nursing Facility, the reimbursement that the SNF receives is reduced from the hosptals reimbursement as that is all part of the diagnosis.Also, any patient transferred from hospital A to hospital B, the two hospitals share the reimbursement. They are not both paid for their costs of providing care.
Where the problem lies with this proposal is the 90 day rule. Too many illnesses can occur with Medicare patients in the 90 days after discharge that have nothing to do with the original diagnosis. But this is government bureaucrats trying to play medical provider and coming up with rules that will never work.
This is why the current reform law will not work. Only in countries where the doctors are part of the national health board or administration where they do not care what reimbursement is does the system work. When doctors are employed by the government, then national health care works. Otherwise, is does not.
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