Hospital Readmissions, Mortality Incentives Alarmingly Misaligned
Higher quality hospitals should be incentivized to focus on improving safety and other services that look at outcomes like mortality, Jha says. For example, it may be that higher quality care results when hospitals and doctors closely track their patients after they are discharged, and rush to rescue them when they get in trouble.
Jha had his analyst run the numbers on the latest list of "best hospitals" named by U.S.News & World Report, which revealed that most of these hospitals do look lopsided. "What you see is a pattern where the best hospitals tend be very low on mortality rates, but tend to be high in readmissions," he says.
Jha made similar comments to journalists attending the Association of Health Care Journalists conference in Atlanta on Sunday.
I noted that for some hospitals the difference is particularly stark.
On Medicare's current Hospital Compare spreadsheet I found Exhibit A: Beth Israel Deaconess Medical Center in Boston, which is "better than" other U.S. hospitals in 30-day mortality rates for all three measured disease categories—heart attack, pneumonia and heart failure.
But Beth Israel is "worse than" other hospitals in 30-day readmission rates in those same diagnoses, and therefore is ripe for a steep readmission penalty starting Oct. 1.
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