Facilitated Quality Competition As A Driver Of Health Care Value

A front-page article in the April 16, 2013 issue of the New York Times announced that “[h]ospitals make money from their own mistakes because insurers pay them for the longer stays and extra care that patients need to treat surgical complications that could have been prevented.” That conclusion came from a study by Sunil Eappen and his co-authors, published in the April 17 issue of The Journal of the American Medical Association. Eappen and his colleagues were not alone in reporting this finding. Last year, we along with William Weeks came to the same conclusion. The two studies demonstrate that hospitals that set out to compete by reducing complication rates face a negative financial impact, and thus raise a policy challenge: how to create effective incentives to improve hospital quality. Well before the two articles appeared, hospitals appeared to act as though they lacked incentives to compete on low complication and mortality rates. Consider the following evidence. (1) Fewer than 10 percent of the nation’s hospitals participate in the American College of Surgeons’ National Surgical Quality Program (NSQIP). Yet, the program allows them to compare their risk-adjusted results to their peers’ and to learn from the best practitioners in the program. (2) Fewer than 45 percent of programs that received three stars – statistically above average in a rating scheme based largely on outcomes – for performing coronary artery bypass grafting (CABG) from the Soci...
Source: Health Affairs Blog - Category: Health Medicine and Bioethics Commentators Authors: Tags: All Categories Competition Consumers Effectiveness Health Care Costs Hospitals Payment Policy Quality Source Type: blogs