Part of the Affordable Care Act focuses on improving the quality of health care by providing financial incentives (or, more accurately, disincentives) for hospitals, based on reducing their “readmission rates” (within 30 days after treatment and discharge) and their “patient harm” (bad things that happen to patients during and because of their hospital stay). The goal of this “Partnership for Patients” program, announced in 2011, is a 20% reduction in readmission rates and a 40% reduction in patient harm before the individual health insurance mandate kicks in on January 1, 2014.
Medicare reimbursements for hospitals with higher readmission rates and patient harm are being cut by 1% now, and that penalty will increase to 3% by 2014. Already, the folks at Medicare tell us that two out of every three hospitals evaluated by them in the U.S. failed to meet the new readmissions and patient harm standards.
...Except in Denver, where I live, and where the flagship “safety net” hospital, Denver Health – a non-profit organization that includes a 477-bed hospital and eight community primary care clinics – has found ways to comply with those standards. One third of its patients are uninsured, and another third are on Medicaid. So, they’re already used to operating on tighter budgets than some other major hospitals. But, using electronic medical records and carefully monitored protocols, as well as standard business models and practices, they have been able to lower mortality rates and reduce infections, mistakes, and redundant testing.
So much so, that they fully comply with the new standards; they have been applauded by the Department of Health and Human Services as a model for other safety-net hospitals across the country, and they’ve cut costs by $100 million in the process.
Way to go, Denver Health! Better quality care with lower costs. That’s what health care reform is supposed to be all about.
That said, what the Affordable Care Act does not yet address in its current form is society’s growing interest in what I would call non-drug-based health care solutions. Recent studies indicate that 40% of Americans spend $34 billion (out-of-pocket) on such approaches to health. Many of these modalities are practiced in addition to conventional, allopathic medical treatments. In fact, some hospitals have set up “integrative medicine” centers because of the demand from patients for these kinds of treatments.