September 15, 2015

Obamacare penalizes hospitals that serve the poor

Vox - An Obamacare program that aims to improve American health care may have an unintended side effect: penalizing hospitals that serve the sickest and poorest patients.

The Affordable Care Act penalizes hospitals that have high readmission rates, where patients come back within 30 days to deal with some complication of the initial procedure. The aim of that program was to encourage doctors to do the best job possible on the first hospital visit, improving patients' experience and saving money by preventing a second trip.

Related The "get more, pay less" era of health care is here

But a new paper from three Harvard health-care experts suggests that the readmission program is penalizing hospitals for the type of patients they see. Hospitals that have high readmission rates tend to see patients who are less educated, more disabled, and more likely to suffer from depression — factors the Obamacare program doesn't account for.

All told, the new Harvard study estimates that about half of the difference in readmission rates can be explained away by patient population characteristics. And that means some of the hospitals could be getting penalized more simply for seeing vulnerable populations.

"The clear implication is this penalty exacerbates the financial strain they're under," says J. Michael McWilliams, an associate professor at Harvard Medical School. "One would worry this would translate into worse-quality care."

1 comment:

Anonymous said...

Any parallels here with school "reform" are left to the reader.