Medicare Starts To Reward Quality, Not Quantity, Of Care | WAMU 88.5 - American University Radio
Filed Under:

Medicare Starts To Reward Quality, Not Quantity, Of Care

Play associated audio

It's no longer enough for hospitals to just send a bill to Medicare and get paid.

The nation's biggest insurer is starting to dole out bonuses and penalties to nearly 3,000 hospitals as it ties almost $1 billion in payments to the quality of care provided to patients.

In what amounts to a nationwide competition, Medicare compared hospitals on how faithfully they followed basic standards of care and how patients rated their experiences. Medicare disclosed on Thursday how individual hospitals will fare when the program, created by the federal health law, begins in January.

In many parts of the country, the hospitals that did the best are not the ones with the most outsize reputations, but regional and community hospitals instead. New York-Presbyterian in Manhattan and Massachusetts General Hospital in Boston, both dominant hospitals in their cities, will have their payments reduced.

Other leading names in the hospital industry, including the Cleveland Clinic and Intermountain Medical Center in Utah, will receive bonuses, although not the largest in their regions.

The biggest bonus is going to Treasure Valley Hospital, a physician-owned, 10-bed hospital in Boise, Idaho, that is getting a 0.83 percent increase in payment for each Medicare patient, the records show. Auburn Community Hospital, a nonprofit near Syracuse in upstate New York, is facing the biggest cut, losing 0.9 percent of every payment for Medicare patients.

"We know we started off at the bottom, but we are going to work our way to much more acceptable scores," said Thomas Filiak, Auburn's chief operating officer. The hospital has already replaced the squeaky wheels on its food carts, which led many patients to note loud noise during their stays, and focused teams of doctors and nurses on improving other areas on which the hospital is evaluated.

In all, Medicare is rewarding 1,557 hospitals with more money and reducing payments to 1,427 others, according to a Kaiser Health News analysis of the records. Most hospitals are seeing far smaller changes than Treasure Valley or Auburn. For many, the bonus or penalty is little more than a rounding error on their bottom lines.

It's not clear that the new payment program will significantly improve hospitals. Some studies of similar incentive programs have found that the improvements ended up not being any better than those of hospitals that weren't prodded financially. Nonetheless, the program is here to stay and is going to expand over the next few years, putting more money into play and adding new quality measures, including patient death rates.

Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.

Copyright 2012 Kaiser Health News. To see more, visit http://www.kaiserhealthnews.org/.

NPR

Stephen Hawking Says Zayn Malik Could Still Be In One Direction In A Parallel Universe

Millions of hearts were broken last month when Zayn Malik left One Direction, but according to physicist Stephen Hawking, that might not be the case after all.
NPR

Competitive Bartender Pours Father's Wisdom Into Signature Drink

Bartender Ran Duan will represent the U.S. in a Bacardi international cocktail competition. His specialty? "Father's Advice," a stirred-not-shaken cocktail that's a testament to his hardworking dad.
WAMU 88.5

Warren Weinstein's Death Has Local Lawmakers Debating Drone Policies

Lawmakers in the D.C. region are mourning the loss of Maryland native Warren Weinstein, who was killed in a U.S. drone strike in Pakistan. The killing has lawmakers debating drone policies once again.
NPR

How Tech Firms Are Helping People In The Nepal Earthquake Zone

Tech and telecom companies stepped up with much needed services. Facebook and Google offered tools to help those in the region let family and friends know they're OK. Other firms cut calling costs.

Leave a Comment

Help keep the conversation civil. Please refer to our Terms of Use and Code of Conduct before posting your comments.