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Medicare Penalized for Being Too Careful
Sounds like a story perfect for the tabloids, but do hospitals really get penalized for being too careful?
Yes and no. The issue is in finding medical issues post treatment. Northwestern Memorial Hospital is being punished for finding too many infections and serious blood clots through testing following treatment. The federal government is cutting the hospital’s funding by $1.6 million.
Medicare is reducing a year’s worth of payments to 758 hospitals, including some of the most prestigious teaching hospitals in the country, with the highest rates of infections and other potentially avoidable complications, including blood clots after surgery, bed sores, hip fractures and sepsis.
The penalties were created by the federal Affordable Care Act, and have uncovered many issues with treatment at academic medical centers. The death rate is lower at Northwestern than at other hospitals, partially due to their dedication to aggressive screenings.
“If you don’t look for infections, you’re never going to find them,” said Dr. Gary Noskin, Northwester’s chief medical officer.
Treating Complications
For the past 8 years Medicare has refused to reimburse hospitals for the treatment of complications they created. However, studies have shown that the lack of reimbursement has not led to reduced risk of harm. Across the country, infections and other avoidable hospital complications remain a threat to patients, occurring during 12 of every 100 hospital stays, according to a federal estimate. According to the study, patients were harmed more than 4 million times during 2014.
The list of hospitalized penalized since last December include Stanford Hospital in California, the Cleveland Clinic, and Brigham and Women’s Hospital in Boston, which trains residents from Harvard Medical School. In addition, two hospitals singled out by President Obama for excellence were also penalized – Intermountain Medical Center in Utah and Geisinger Medical Center in Pennsylvania.
On average it is estimated that hospitals have had to pay about $480,000 in penalties. Many academic centers will be charged more as they earn higher revenues. Medicare does note that teaching hospitals are improving at a faster rate than other hospitals.
Dr. Atul Grover, chief public policy officer at the Association of American Medical Colleges says that the fines hurt hospitals, including academic centers, that have the sickest patients. Medicare is “punishing hospitals for taking on cases that nobody else wants, Grover said.
How do you feel about the fines imposed by Medicare? Do they think they hurt or protect patients? Share your thoughts.