An economist says it's smart for Medicare to fine hospitals for
readmitting too many patients within 30 days of discharge due to
complications that could have easily been avoided.
Devon Herrick, Ph.D., a healthcare economist with the National Center for
Policy Analysis, says it is generally a good idea for Medicare
to refuse to pay for a hospital's mistake.
"So any dollar you can save by not having to readmit
someone who really didn't need to be readmitted is a good thing to
save taxpayers money and really improve the health of people who
otherwise would have to go back to the hospital for things that
could have been avoided," Herrick explains.
Part of the problem is that some patients are discharged
and not given instructions on how to care for themselves, or they
are discharged to a nursing home and "dumped on the next provider"
with no follow-up on the patient.
Herrick points out that the Geisinger Health System in
Pennsylvania has offered insurers a limited warranty of sorts for
certain cardiac surgeries in exchange for a higher reimbursement
level. He thinks that is a great idea that others should follow,
and one that Medicare should require.
"A lot of service industries provide warranties on the work that
they do, so why not hospitals that treat Medicare patients," the
The penalty is being capped this year at one percent of a
hospital's Medicare payments. Herrick compares that to a slap
on the wrist when it comes to protecting taxpayer dollars (
see earlier related story).
For now, hospitals are being measured on three medical
conditions: heart attacks, heart failure and pneumonia, which may
present another problem. For example, Dr. Jane Orient,
executive director at the Association of American Physicians and
Surgeons, points out that heart failure is a chronic condition;
regardless of how well a doctor may treat a patient, that person
may get sick again within 30 days and need to go back to the