Back in 2015, the Harvard group published a comprehensive study on the effects of Medicare’s punitive non invasive method for hospital-acquired infections. The writers studied nearly 400 hospital or hospital programs for around a total of over 28,000 unit-months. They analyzed catheter-associated urinary tract ailments and catheter-related blood infections – for which Medicare had established punitive non invasive coverages, and hospital-acquired pneumonia for which there were no punitive policies in the moment. The results, shown in their figure reproduced below, show clearly that for three infection forms, the disease rates were decreasing before Medicare implemented their coverage and the rate of reduction did not alter following policy implementation for any disease type. I concluded from these data that doctors had understood that hospital-acquired infections weren’t great for patients rather than great for their bottom line until Medicare’s policies and the punitive measures didn’t hasten the hospitals’ attempts to remove these illnesses. I was particularly interested in those data because the little hospital at which I volunteered in their disease prevention committee had incurred a punitive non-payment the calendar year ahead of this publication of the report.
Fast forward to 2020. Writers in the Harvard system once more analyzed the impact of Medicare’s punitive paychecks policies on disease prices. They especially compared “safety-net” and non-safety-net hospitals. “During October 2014, those applications started comparing hospital performance selected disease metrics with federal benchmarks according to potential disease surveillance data reported on the National Healthcare Safety Network (NHSN) of the Centers for Disease Control and Prevention. At the moment, HVBP rewards or penalizes the greatest – and – lowest-performing hospitals by around 2%of their overall inpatient obligations the hospital obtained, whereas the HACRP reduces payments by around 1% for the lowest actors.” In this circumstance, the group analyzed data from 600 physicians who filed their information to CDC’s National Healthcare Safety Network (NHSN) system over recent years 2013-2018. Yet more, these punitive measures neglected to enhance the rates of four nosocomial infection forms studied. The authors suggest these measures have a comparatively greater monetary impact on safety-net hospitals for no appreciable advantage in disease prevention. In addition they demonstrate that Medicare has heard little during the previous ten years of expertise since implementing these kinds of measures.
I continue to feel that many hospital administrations know what is ideal for their patients is what’s ideal for their physicians and that they attempt to behave accordingly. While I am certain there are exceptions to this, it’s apparent that the Medicare policies are currently doing more damage than good. So as to further lower disease rates, we likely need a better knowledge of the several aspects that contribute to increased prices, such as patient risk factors, hospital staffing, along with many others such that we are able to direct hospitals to consider the steps that must lower prices further.
It is 1 thing to employ an overall coverage with no regard to the particular factors one attempts to change and another to employ certain policies tailored to the requirements of different institutions. I suggest it is the former strategy that’s most wanted.