Greenbeard
Gold Member
- Thread starter
- #41
It's why the Intermountain folks noted that even for them, value improvements have been accompanied by financial penalties.
Tell me something, why does making a profit cost a company money?
Are you taking the phrase "value improvement" to be synonymous with "profit"? If so, why?
The regulations that are written by bureaucrats in Washington are nuetral or negative toward quality, and actually tend to pay more when providers deliver poor quality than they do for high quality. In other words, they are designed to limit profit by paying companies to deliver bad service. These regulations were written with the goal of increasing quality and making costs lower. Yet, as you have just argued, they actually do just the opposite.
None of the sentences you've written have any logical relationship to each other. Beyond being mutually contradictory, that is (quality-neutral payment policies cannot, by definition, be "written with the goal of increasing quality").
Presumably you're referring to this:
In the Medicare program, the payment system is largely neutral or negative towards quality. All providers meeting basic requirements are paid the same regardless of the quality of service provided. At times providers are paid even more when quality is worse, such as when complications occur as the result of error.
At this point I have to stop and congratulate you. It took 4 pages but you've stumbled over the theme of this thread (one I've mentioned explicitly multiple times now): current payment policy (in both the public and private sector) often doesn't reward value improvements, i.e. increasing quality relative to costs. That's precisely because they weren't designed to reward value. Which means, as MedPAC was kind enough to point out in that 2003 report, those payment policies have to change. Those recommendations weren't acted on in any large-scale fashion until 2010 but now legislative action has been taken paving the way for exactly that.
It's not clear whether you're arguing for retaining the status quo and hoping for the best, or for ending Medicare. Presumably it's the latter. Shocking.