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Bad Practices Net Hospitals More Money
Bad Practices Net Hospitals More Money -- Posted by Raymond on 07-24-05 04:46
CHRONIC CONDITION The Waste in Medicare Spending
Bad Practices Net Hospitals More Money
High Quality Often Loses Out In the 40-Year-Old Program
"The accomplice to the crime of corruption is frequently our own
indifference"
--- Bess Myerson
By Gilbert M. Gaul
Washington Post Staff Writer
Sunday, July 24, 2005; Page A01
First of three parts
As far back as 1999, federal and state regulators began to receive
complaints that the heart surgery unit at Palm Beach Gardens Medical
Center in Florida was a breeding ground for germs
Dust and dirt covered some surgical equipment. Trash cans and soiled
linens were stored in hallways. IV pumps were spattered with dried
blood. One patient's wife said she saw a medical assistant tear
surgical tape with his teeth.
State inspectors in 2002 found "massive post operative infections" in
the heart unit, requiring patients to undergo more surgery and lengthy
hospital stays.
In a four-year period, 106 heart patients at Palm Beach Gardens
developed infections after surgery, according to lawsuits and
government records. More than two dozen were readmitted with fevers,
pneumonia and serious blood infections. The lawsuits included 16
patients who died.
How did Medicare, the federal health insurance program for the elderly,
respond?
It paid Palm Beach Gardens more.
Under Medicare's rules, each time a patient comes back for another
treatment, a hospital qualifies for an additional payment. In effect,
Palm Beach Gardens was paid a bonus for its mistakes.
Medicare's handling of Palm Beach Gardens is an extreme example of a
pervasive problem that costs the federal insurance program billions of
dollars a year while rewarding doctors, hospitals and health plans for
bad medicine. In Medicare's upside-down reimbursement system, hospitals
and doctors who order unnecessary tests, provide poor care or even
injure patients often receive higher payments than those who provide
efficient, high-quality medicine.
"It's the exact opposite of what you would expect," said Mary Brainerd,
chief executive officer of HealthPartners, a nonprofit health plan
based in Bloomington, Minn. Her Medicare HMO ranked among the top 10 in
the nation last year for quality but was paid thousands of dollars less
per patient by Medicare than lower-performing plans.
"The way Medicare is set up," Brainerd said, "it actually punishes you
for being good."
As Medicare approaches its 40th anniversary on Saturday, much of the
debate about the nation's largest health insurance program revolves
around whether it will remain solvent for aging baby boomers. Yet
another critical question is often overlooked: whether taxpayers and
patients get their money's worth from the $300 billion Medicare spends
each year -- now about 15 percent of federal spending and projected to
grow to nearly a quarter of the budget in a decade.
CONTINUED;
SEE:
http://www.washingtonpost.com/wp-dyn/content/article/2005/07/23/AR2005072300382.html
"Money and corruption are ruining the land. Crooked politicians betray
the working man, Pocketing the profits and treating us like sheep, And
we're tired of hearing promises That we know they'll never keep"
--- Ray Davies
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