10 Ways CMS's Value-Based Purchasing Proposal is Flawed
Wrote Stacie Neff of Clallam County Hospital District in Washington State, "Before CMS gives/sells CMS performance data to outside vendors/researchers, we would want rigorous assurances and safeguards to ensure our patient’s privacy and confidentiality."
10. Safety net hospitals can't be judged by the same standards as the typical American hospital, Ellen Kugler, executive director of the National Association of Urban Hospitals, wrote . The VBP regulations assume that in an emergency room, "physicians can make a swift, clear, and specific diagnosis." This is challenging when patients in low-income, urban safety net hospitals are fundamentally sicker, with years of neglect and with co-conditions that mask or are more prominent than an underlying condition associated with a specific quality measure, she wrote.
There were a lot more objections in these letters, but more on that in later columns.
Though many of the comments on the CMS website were negative, not all were. Here's one from Vivian Lauderdale of Encinitas, CA.
"Dear CMS: I am a grandmother, mother, health technology professional and have had a personal experience with harmful healthcare events. Please record my full support of the proposed rule ... because it can have enormous impact on our healthcare due to the fact that hospitals will only be paid if they are accountable for safety improvement. ...There may be many special interest groups that oppose this rule; however, I believe that the data or measures do not need to be perfect to move the motivations of America's healthcare leaders and caregivers to improving care in this country."
After reading these comments and watching the state of paralysis and disagreement in which healthcare providers seem to find themselves in right now, another favorite line from Firesign's repertoire springs to mind:
"How can you be in two places at once when you're not anywhere at all." In my humble opinion, we should all move forward with healthcare reform and fix problems along the way. As the saying goes, let not the perfect be the enemy of the good.
To read more about what providers and others think about CMS' VBP regs, visit regulations.gov and search "Comments" with the keyword CMS-2011-0003
Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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