Hospitals make more money when they make mistakes during surgery, and reducing mistakes could actually cut into a hospital's profits, according to a new study.
The study's authors suggest that changing the way people pay for hospital care could reduce complications, while maintaining the status quo could keep hospitals from trying to improve. On average, a surgery with complication netted a hospital $1,749 more for every patient on Medicare, or $39,017 more for a patient with private insurance, compared to a complication-free procedure.
The study doesn't mean that surgeons deliberately make mistakes to rake in the dough for hospitals, David Sadoff, one of the study's authors and a managing director at the Boston Consulting Group, told The New York Times. "We don't believe that is happening at all," he said. But it does mean that without change, there's little incentive to improve.
Sadoff and his colleagues—including researchers from the Boston Consulting Group, Harvard University and Texas Health Resources, which runs three large, nonprofit hospitals—had some specific suggestions for fixes, The New York Times reported. They recommend that insurers should not pay for poor care, but should give out bonuses for complication-free procedures. They also suggest that hospitals be required to post their complication rates publicly, so that people may choose to avoid poorly performing ones, forcing those places to change or close.
The researchers got their numbers from analyzing the medical charts from more than 34,000 surgeries at Texas Health Resources. Inspiration for the study came in part from the fate of previous studies that showed a simple checklist could drastically reduce surgical mistakes. (You may have seen the 2007 New Yorker article describing it.) In spite of the evidence, not many hospitals tried the checklist, Atul Gawande, The New Yorker article's author and a Harvard University surgeon and medical professor, told The Wall Street Journal. "We wondered whether finances were playing a part in it," Gawande said.
"...Hospitals make more money when they make mistakes during surgery, and reducing mistakes could actually cut into a hospital's profits, according to a new study..."
That sentence should open the fire hydrant to comments, I imagine.
I wish there was a solution for the consistent rising cost of health care. I know as I age getting closer to death, it just somebody else’s win fall, other than my relatives
..... sad sigh.
If you want behaviors to change, you have to drive it with the right incentives.
If hospitals MAKE MORE MONEY when they make mistakes, then they WILL MAKE MORE mistakes. If there are no downsides for the hospitals to NOT improve, then they certainly don't have any incentives TO improve. If they will actually PROFIT from their mistakes, then why would they EVER improve?
How is that a surprise?
"We Entertain When It Rains"
Health care professions have no incentive to make you healthy. They don't make money off healthy patients. They will keep you alive, but dependent on their services. This is the reason that diseases tend to be over-diagnosed and patients over-medicated.
Of course this varies from practice to practice, there are still some good moral people out there. But many more bend to the will of the bean counters, pharmaceutical companies, and their own greed.
This is what I hoped health care reform would address. What we got is ObamaCare, which doesn't directly address any of the underlying problems of health care in the US.
Yes, hospitals and doctors make mistakes. Not all complications are a result of errors doctors or hospitals.
Following by 5 week a total knee replacement in April 1992, staph infection was took hold in the bone. Most people blamed the doctor an/or hospital, but that was not true in my case. It as my fault.
I allowed the surgical site to get wet by accident 4 weeks post-surgical. That's all it took since staph aureus
is present on human skin naturally.
Yes, it was difficult and expensive to eliminate nut not the hospitals or my doctors fault as is commonly believed. Sometimes stuff happens. That's life.
It is all a result of the payment model used for health care. Doctors and hospitals get paid to do procedures, exams, and tests. When there are complications, more procedures, exams, and tests are done. When there are no complications, fewer are done and therefore less money is earned. Of course they could make up for the loss by seeing more patients, but they would be going against the perverse incentives of the pay-per-service model.
There have been all sorts of ideas on how to instead pay the doctors and hospitals more for a good result, and less for a bad one. But there is too much fear that it will lead to providers cherry-picking only the most promising patients (kind of like insurance companies). Figuring out how to measure and pay for healthcare outcomes will get just as political and nasty as measuring school performance.
Hbilly, we had a Humana through the Commonwealth of KY employees health plans in 1992. She is a special ed teacher and I was a elementary school custodian. The first bill we received was the actual hospital statement and the total was $43,ooo. Humana PPO paid a total benefit of $4880. That included the surgeons fee for the surgery and follow-up office calls, the joint itself ($12,000 if we had paid the bill with no insurance), AND the entire hospital stay of 7 days.
All healthcare costs could be greatly reduced if everyone paid cash for their medical expenses. I have an HSA and this is what I do. I have negotiated with a hospital for ER costs and saved almost 50% by paying cash.
Rather than going to a single-payer healthcare system in the US, where no one has to take personal responsibility for the cost burden of their medical care, we should give every US citizen a federally-backed health care account. Each individual can contribute as much, or as little, money to the account each year tax-free as they choose to. And any time they have medical care expenses, they can charge the costs to their account. If they do not have sufficient funds in the account to cover the costs, the federal government will loan them the balance required. But the individual will be required to pay the loan back when they are able to.
Under this system, every citizen will be able to access whatever type or quality of medical care they feel is necessary. But they will also be held responsible for eventually paying for it themselves, so there will be a big incentive to spend wisely.
Hospitals should not be for-profit. The end.
I'm not sure that I agree with the premise that hospitals MAKE more money for mistakes. I will grant you that they may receive more for a given procedure if there are problems -- but that does not necessarily equate to more on the bottom line.
Insurers have complex agreements with all providers. My bills often show a line called 'provider responsibility' -- that is, 'sorry you can't charge that much'. I don't know that they don't penalize for cases that go wrong.
Also, the unexpected can raise heck with costs -- plans have to be shifted and things put through on a rush basis --things that often cost more, but they can only charge at a fixed rate.
Finally there is good old litigation. 'Bad outcome' insurance is expensive -- and rates can only go up if the providers get sued more frequently. Which they will if they do sloppy work.
Not to mention that the prople there probably are trying to do a good job.