This is a great start, this must happen in order for real reforms to be a reality.

 

> >Subject: Common Sense Idea from Washington? Pilot Test will pay Hospitals for Quality >Date: Sun, 13 Jul 2003 17:38:08 -0400 > >http://www.washingtonpost.com/wp-dyn/articles/A40299-2003Jul10.html > >Pilot Test Will Pay Hospitals For Quality >Government Hopes Care Will Improve >By Ceci Connolly >Washington Post Staff Writer >Friday, July 11, 2003; Page A03 >In a pilot project the Bush administration says could spur improvements in >American medicine and a more rational health care pricing system, officials >announced yesterday that they intend to pay a total of $7 million a year in >bonuses to hospitals that score well on 35 quality measures. >Under the program, hospitals that provide superior care for five conditions >-- heart attack, heart failure, pneumonia, coronary artery bypass surgery, >and hip and knee replacements -- will be eligible for higher Medicare >reimbursements. >Report cards on the hospitals' performance will be posted on the Internet, >and if the effort succeeds, the administration will attempt to recalibrate >the entire Medicare payment structure to one that rewards performance, said >Tom Scully, administrator of the Centers for Medicare and Medicaid Services. >Through competition, "our hope is all ships will rise together," said >Scully, who has dreamed of a performance-based fee system since taking over >the agency in 2001. He predicted that doctors, nurses and administrators at >underperforming hospitals will quickly take steps to improve their scores. >That, in turn, could spark a mini-revolution in health care pricing by >spurring private insurers to follow suit, said labor leaders and consumer >advocates who support the project. >Gerry Shea, chief policy officer of the AFL-CIO, said corporations "have >been dying to do this kind of thing" but needed the government to take the >lead. >Whether care is top-notch, mediocre or downright dangerous, the price is the >same, Shea complained. "We don't buy anything else the way we buy health >care," he said. >When it comes to hospitals, Medicare is the behemoth customer. The program >spent $93.2 billion on inpatient care in 2001, nearly 70 percent of all >hospital revenue. Generally, private purchasers set their payment schedules >in line with Medicare reimbursement rates. >Paying for performance "is the way of the future," said John Rother, policy >director at the AARP, an advocacy group for people age 50 and older. >Since the Institute of Medicine issued its landmark "To Err is Human" report >in 1999 documenting the health and financial costs of medical errors, >pockets of the health care industry have been trying to develop standards >for quality. But more dramatic changes, such as publishing performance >results or linking payment to those measures, have been slow in coming. >Last December, the hospital industry announced it was developing a voluntary >system to provide consumers with performance scores on 10 indicators of good >medical treatment for three common but serious maladies. Once the program is >up and running, patients will be able to see how often hospitals used the >"best practices." For instance, consumers will be able to look on a Web site >to see what percentage of patients with congestive heart failure had their >heart function tested after they were admitted to the hospital or how often >pneumonia patients received the vaccine against pneumococcal bacteria. >Scully, however, described yesterday's initiative as a "much more aggressive >and extensive measurement of outcomes." Under an agreement with Premier, a >consortium of 550 not-for-profit hospitals, participating hospitals will >report how many patients received widely accepted treatments considered >"best practices." For heart attack cases, for example, hospitals will tally >how many patients received an aspirin on arrival, smoking cessation >counseling and beta blocker medications. They also will report the inpatient >mortality rate for heart attack patients. >Premier hospitals scoring in the top 10 percent will receive a 2 percent >bonus on their Medicare payments for those services; hospitals in the next >10 percent will get a 1 percent bonus. In the third and final year of the >program, any hospital that has not met minimal improvement levels will be >penalized as much as 2 percent, Scully said. >Over the next three years, CMS expects to pay $21 million in performance >bonuses, but officials predicted that money will be easily made up in >savings from better health outcomes such as fewer relapses and return visits >to emergency rooms. >"This will save money for the Medicare system without any doubt whatsoever," >said Health and Human Services Secretary Tommy G. Thompson. >Premier, which already collects extensive data, said it expects 300 to 400 >of its hospitals to participate in the voluntary program. The company has >been investigated recently for potential conflicts of interest relating to >its joint purchasing practices of medical supplies. Yesterday, Scully said >the purchasing cooperative was separate from the member hospitals and should >have no impact on the quality initiative. >© 2003 The Washington Post Company > <<...OLE_Obj...>> <<...OLE_Obj...>> >