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Tag Archives: News Commentary

Hospitals Getting Graded Using Wrong Test Questions

So the Department of Health and Human Services’ “report card” grading hospitals on how well the hospitals “care for all their adult patients with certain medical conditions” just keeps getting worse and worse. Now we’re seeing that the “quality indicators” the government is using are nothing of the sort. One recent study shows that at least one set of “quality indicators” Increases the likelihood of misdiagnosis, Causes patients to receive unnecessary antibiotics, Has no effect on patient length of stay or death rates Not mentioned in the article, but just as important – increases the costs that patients have to pay due to all the unnecessary antibiotics and blood cultures Jumping through all the government hoops makes patients more likely to be misdiagnosed and more likely to receive unnecessary antibiotics. And they’re the ones grading the hospitals? The HHS home page states “This information will help you compare the quality of care hospitals provide.” Funny thing . . . if you look around on the web site, it shows nothing about where the quality indicators came from or what scientific methods were used to come up with the indicators. This page lists all of the quality indicators that HHS uses to determine whether or not patients are receiving “quality care.” If you go to the Pneumonia “Process of Care Measures” you’ll see that HHS thinks that “quality hospitals” give antibiotics within 4 hours because “Timely use of antibiotics can improve the treatment of pneumonia caused by bacteria.” Great. So why the 4 hour time frame? There are no data on the web site to support the government’s “quality indicators.” Now at least one study shows that the 4 hour time frame may actually harm patients. And why does HHS equate quality of care with giving unnecessary antibiotics to patients with viral pneumonia? Some of the quality indicators are valid. But let’s not use smoke and mirrors to coerce hospitals into providing unnecessary and potentially harmful care so that they can be at the top of some report card. The patients in the US deserve better than this. On tap in the future – more than 100 new “quality indicators” by which hospitals will be expected to abide. Just how many of them will have a scientific basis? I’m not keeping my hopes up. This micromanagement is going to make healthcare in the US more expensive and less effective. One more thing – has anyone ever noticed that government-run hospitals aren’t on the HHS “Hospital Compare” website? Try searching for Walter Reed Army Medical Center or Tripler Army Medical Center, for example. If civilian hospitals are performing as well as government-run facilities, they should get a great grade, right? Why aren’t government-run hospitals available for comparison? Bottom line: If everyone ignores these indicators, they become meaningless. No quality indicators for the Department of Health and Human Services leadership . . . yet.

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Refuse Medicaid patients, get sued

According to a July 23 article in AM News, the Illinois attorney general is suing two Illinois clinics because they made a business decision not to accept new Medicaid patients. Let’s look at the facts: According to the AMA, Illinois is one of 17 states in a medical liability crisis. Three of the American Tort Reform Association’s top six “judicial hellholes” are located in Illinois. Illinois pays next to nothing for physicians to see Medicaid patients. This article implies that Illinois is paying physicians $30 per visit for Medicaid patients when it costs the physicians $300 per hour just to keep the doors open. No, I take that back. In some cases, Illinois doesn’t pay next to nothing to healthcare providers who see Medicaid patients. Instead, Illinois pays nothing at all. Illinois’ Medicaid program already owes $1.5 billion in late payments to pharmacists, doctors, nursing homes, and other medical providers who have provided care to Medicaid patients. See the article “Illinois Medicaid Takes on New Costs – Governor accused of ignoring unpaid bills” and the article “Illinois’ Medicaid money to hospitals MIA“. Oh, and by the way, the public hospitals in Cook County are cutting services because the county and state don’t have the money to pay for them. See Doctors leaving Stroger Hospital So Illinois has one of the worst malpractice climates in the US, it costs the involved clinics money every time they see a state-funded patient, the state isn’t paying the clinics the small amount of money the state owes them for taking care of state-funded patients, and the state is partly to blame for closures at the county hospitals where state-funded patients could go to be seen. The clinics make a responsible business decision to stop seeing patients because they lose money and increase liability every time they take care of a patient. Now Lisa Madigan has the gall to sue the clinics? Let’s look at what will happen if this lawsuit is successful: Illinois continues to collect billions of dollars in taxes to fund care of public aid patients Illinois cuts back on more medical services and closes more public clinics because of “lack of funding” Public aid patients have nowhere to go for care, so they seek care at private clinics State doesn’t pay private clinics for taking care of public aid patients Private clinics lose more and more money until they make business decision to stop seeing public aid patients State sues private clinics to force them to continue caring for publicly-funded patients without being paid or being grossly underpaid State saves billions of dollars per year in what amounts to court-ordered involuntary servitude against health care providers. Good business decision, Ms. Madigan. Way to attract more health care providers to do business in Illinois. What’s next – suing people who decide to quit their state government jobs to force them to keep working for substandard wages? Does your dad have anything to do with this lawsuit? I included the complete text of the AM News article below for those who don’t have access to the AM News web site.

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