Change is upon the health care industry and while some of it may require painful adjustments, in the long run, much of it will benefit everyone, especially patients.
The pain was evident last week as the federal government penalized Kaleida Health for having high rates of infections or other patient safety problems. It’s part of a push to reduce medical errors and, as a result of the finding, Kaleida will see its Medicare payments reduced by about $1.7 million over the next four years.
More than just reducing medical errors – as important as that is – the effort has an even larger purpose: to help transform the American health care system from one that pays for procedures to one that pays for outcomes. It’s a critical rethinking of the system, and if Kaleida is being pinched by it today, so are the 723 other health care providers around the country that were penalized. Those include the Wyoming County Community Health System in Warsaw, which will lose about $75,000.
There are many reasons the U.S. health care system is simultaneously the world’s most expensive yet only mediocre in its results, but clearly, a system that tolerates avoidable errors and, in effect, rewards providers for followup treatments that could have been avoided is building in waste and ill health.
The scoring that produced penalties for hospitals is complicated and not without its critics. For example, while the scoring system attempts to account for risk factors such as age, gender and severity of illness, it is difficult to devise a formula that fairly and accurately represents the work that goes on every day.
Nevertheless, from a social perspective, there is at least broad-based value in the effort. Indeed, Kaleida tacitly acknowledged some previous weaknesses in observing that it already took steps this year to improve patient conditions. Among those steps are a new quality improvement and patient safety plan. It has also hired a systemwide chief medical officer, new chief medical officers for all of its hospitals and a new vice president for quality improvement.
The Wyoming County hospital says its score was based on limited data from a three-year period that ended in 2013. It also noted that another organization, the New York State Partnership for Patients, praised the hospital for its efforts to reduce hospital-acquired conditions.
It’s good that both the Wyoming County facility and Kaleida are working to improve, as we presume the hospitals that weren’t on the list are also doing. Improvement is a process, not a destination.
No one has even hinted that these are unsafe hospitals, but there was plainly room to do better. That pressure to keep getting better is not likely to ease up anytime soon, as the country grapples with the cost and results of health care.