An existing government website has recently expanded to include the patient safety ratings of thousands of U.S. hospitals. This site, Medicare's Hospital Compare features data on surgical complications, infections and potentially avoidable deaths. Sound intriguing? Useful? Consumer-friendly? This is the first step towards government based reductions of Medicare reimbursement of hospitals that don't 'make the grade.' But hold the line and consider the following....
While some information provided on the Medicare website has some usefulness to the average patient; let us examine what this might mean for an individual who suffers from multiple medical co-morbidities and presents a high surgical risk. Such patients are becoming increasingly common today with an aging population that has survived, because of modern medicine, many of the ailments that prior generations succumbed to.
If hospital reimbursement becomes linked to patient outcomes, there will be nothing to stop a facility from refusing to accept high-risk patients and refusing to perform complex procedures on this population who carry with them a good chance of suffering complications because of their inherent compromised pre-existing health condition. So hospitals could choose to admit only low-risk patients to keep their statistics buoyed up to acceptable government parameters, forcing the sickest patients to be cared for in 'tertiary care' centers likely far from home. Physicians already experiencing dwindling Medicare reimbursement rates may simply choose to shy away from this group of patients and opt to care for those with private insurance and/or those that present much less risk from pre-existing health issues.
While accountability and drawing back the curtain so consumers can see into how health care is practiced in this country is a good thing, beware and be cautious with the published data. Understand that if this broad brush is applied to all hospitals, regardless of a policy of accepting and caring for the sickest of the sick, it is within the realm of possibility that these facilities will re-think taking in these sorts of patients and simply shy away, forcing people to travel long-distances to be cared for in larger institutions.




