Hospitals save $100 million in Medicare costs under state experiment

[Arianrhod]

Hospitals could save a lot of money if we allowed them to turn away people at the ER.

Medicare already fines hospitals millions for what they deem "unnecessary" treatment....so why not.

Links?

 

[Stephanie]

what the hell is wrong the people in Maryland.

when did we start living by a Globull budget? You better open your eyes. Obama has sold us out to UN

At first I thought this was a joke but then I saw the poster. Global here means inclusive of all inpatient and outpatient revenue received by a hospital for the calendar year. It doesn't mean global as in Planet Earth. No U.N., no Illuminati.

I'm glad this thread was bumped though, because the first results published in NEJM came out last November. They were extremely promising.

In 2013, Maryland committed to limiting annual growth of per capita hospital costs for all payers to 3.58%,the historical growth rate of the gross state product. According to hospital financial reports and claims, these costs grew by 1.47% between 2013 and 2014 for Maryland residents treated at Maryland hospitals — 2.11 percentage points lower than the agreed-on growth rate (see graph).

In 2014, Medicare’s per capita hospital costs grew by 1.07% nationally and decreased by 1.08% in Maryland. Given these trends, Maryland has already saved Medicare $116 million.

By implementing a quality-incentive program in which hospitals’ global budgets were adjusted on the basis of all-payer performance on these measures, Maryland was able to reduce the rate of potentially preventable conditions by 26.3% between 2013 and 2014, according to its Health Services Cost Resource Commission.

A number of the 65 potentially preventable conditions also overlap with conditions in Medicare’s Hospital-Acquired Condition program. Maryland reduced the rates of almost all these conditions among patients covered by all payers and among Medicare patients (see table).

Meanwhile their hospitals continue to exceed every target they agreed to in their negotiations with the feds.

And their hospitals are still good: Johns Hopkins remains a top three hospital nationally (behind only Mass General and Mayo), despite being on a budget for over a year now.

This remains one of the most interesting experiments in the country right now. We'll see where it goes.

yeah yeah, you would know, you are being paid by them probably and from OScamNocare too. Of all things to cut money out of the program that services the poor, seniors etc. how lovely of you

 

[Arianrhod]

what the hell is wrong the people in Maryland.

when did we start living by a Globull budget? You better open your eyes. Obama has sold us out to UN

At first I thought this was a joke but then I saw the poster. Global here means inclusive of all inpatient and outpatient revenue received by a hospital for the calendar year. It doesn't mean global as in Planet Earth. No U.N., no Illuminati.

I'm glad this thread was bumped though, because the first results published in NEJM came out last November. They were extremely promising.

In 2013, Maryland committed to limiting annual growth of per capita hospital costs for all payers to 3.58%,the historical growth rate of the gross state product. According to hospital financial reports and claims, these costs grew by 1.47% between 2013 and 2014 for Maryland residents treated at Maryland hospitals — 2.11 percentage points lower than the agreed-on growth rate (see graph).

In 2014, Medicare’s per capita hospital costs grew by 1.07% nationally and decreased by 1.08% in Maryland. Given these trends, Maryland has already saved Medicare $116 million.

By implementing a quality-incentive program in which hospitals’ global budgets were adjusted on the basis of all-payer performance on these measures, Maryland was able to reduce the rate of potentially preventable conditions by 26.3% between 2013 and 2014, according to its Health Services Cost Resource Commission.

A number of the 65 potentially preventable conditions also overlap with conditions in Medicare’s Hospital-Acquired Condition program. Maryland reduced the rates of almost all these conditions among patients covered by all payers and among Medicare patients (see table).

Meanwhile their hospitals continue to exceed every target they agreed to in their negotiations with the feds.

And their hospitals are still good: Johns Hopkins remains a top three hospital nationally (behind only Mass General and Mayo), despite being on a budget for over a year now.

This remains one of the most interesting experiments in the country right now. We'll see where it goes.

yeah yeah, you would know, you are being paid by them probably and from OScamNocare too. Of all things to cut money out of the program that services the poor, seniors etc. how lovely of you

You don't seem to understand that the cuts are in terms of paperwork and redundancies, not services.

Have your services been cut? Do you ever know what you're talking about?

Why do you believe it's moral, Christian, and good sense to turn people away from the ER and let them die in the parking lot?

You got some 'splainin' to do.

But please do ignore this post as you do everything that doesn't fit your selfish worldview.

 

[BlueGin]

Hospitals could save a lot of money if we allowed them to turn away people at the ER.

Medicare already fines hospitals millions for what they deem "unnecessary" treatment....so why not.

Links?

Again.

Why is it you never know anything related to healthcare?

Medicare Fines 2,610 Hospitals In Third Round Of Readmission Penalties

 

[Arianrhod]

Hospitals could save a lot of money if we allowed them to turn away people at the ER.

Medicare already fines hospitals millions for what they deem "unnecessary" treatment....so why not.

Links?

Again.

Why is it you never know anything related to healthcare?

Medicare Fines 2,610 Hospitals In Third Round Of Readmission Penalties

Which, if you really were in the healthcare business, you'd understand as a function of excessive billing.

Example: Medicare patient with CHF and comorbidities requires a TAVR. Cardiologist, cardiac surgeon, sleep specialist, etc., etc., etc. require multiple EKGs, echocardiograms, sleep studies, MRIs, rinse, repeat in order to come to the same conclusion: Patient needs a TAVR.

Why do they do this? Because the hospital they're affiliated with is one of the top hospitals for cardiac surgery in the nation. If the patient dies before he undergoes surgery, it doesn't make them look bad. The longer they can stall and keep billing Medicare, the better.

 

[BlueGin]

Hospitals could save a lot of money if we allowed them to turn away people at the ER.

Medicare already fines hospitals millions for what they deem "unnecessary" treatment....so why not.

Links?

Again.

Why is it you never know anything related to healthcare?

Medicare Fines 2,610 Hospitals In Third Round Of Readmission Penalties

Which, if you really were in the healthcare business, you'd understand as a function of excessive billing.

Example: Medicare patient with CHF and comorbidities requires a TAVR. Cardiologist, cardiac surgeon, sleep specialist, etc., etc., etc. require multiple EKGs, echocardiograms, sleep studies, MRIs, rinse, repeat in order to come to the same conclusion: Patient needs a TAVR.

Why do they do this? Because the hospital they're affiliated with is one of the top hospitals for cardiac surgery in the nation. If the patient dies before he undergoes surgery, it doesn't make them look bad. The longer they can stall and keep billing Medicare, the better.

And they fine hospitals unfairly. Which btw are usually the hospitals serving the poorest communities .
***************************************

"Dr. Don Goldmann, chief medical and science officer at the Institute for Healthcare Improvement, a Massachusetts nonprofit, cautioned against attributing the drop in readmissions only to the penalties, since the government also has other, less punitive programs underway. “There’s so much at play,” Goldmann said. “I’d be careful about imputing the reduction to any one intervention.”

As the penalties have played out, an increasing number of prominent experts are voicing concerns that the punishments are too harsh and doled out unfairly. For one thing, Medicare lowers payments to hospitals even if they have reduced their readmission rates from the previous year—so long as their rate is still higher than what the government believes is appropriate for that hospital. Medicare uses the national readmission rate to help decide what appropriate rates for each hospital, so to reduce their fines from previous years or avoid them altogether, hospitals must not only reduce their readmission rates but do so better than the industry did overall."

 

[Arianrhod]

Hospitals could save a lot of money if we allowed them to turn away people at the ER.

Medicare already fines hospitals millions for what they deem "unnecessary" treatment....so why not.

Links?

Again.

Why is it you never know anything related to healthcare?

Medicare Fines 2,610 Hospitals In Third Round Of Readmission Penalties

Which, if you really were in the healthcare business, you'd understand as a function of excessive billing.

Example: Medicare patient with CHF and comorbidities requires a TAVR. Cardiologist, cardiac surgeon, sleep specialist, etc., etc., etc. require multiple EKGs, echocardiograms, sleep studies, MRIs, rinse, repeat in order to come to the same conclusion: Patient needs a TAVR.

Why do they do this? Because the hospital they're affiliated with is one of the top hospitals for cardiac surgery in the nation. If the patient dies before he undergoes surgery, it doesn't make them look bad. The longer they can stall and keep billing Medicare, the better.

And they fine hospitals unfairly. Which btw are usually the hospitals serving the poorest communities .
***************************************

"Dr. Don Goldmann, chief medical and science officer at the Institute for Healthcare Improvement, a Massachusetts nonprofit, cautioned against attributing the drop in readmissions only to the penalties, since the government also has other, less punitive programs underway. “There’s so much at play,” Goldmann said. “I’d be careful about imputing the reduction to any one intervention.”

As the penalties have played out, an increasing number of prominent experts are voicing concerns that the punishments are too harsh and doled out unfairly. For one thing, Medicare lowers payments to hospitals even if they have reduced their readmission rates from the previous year—so long as their rate is still higher than what the government believes is appropriate for that hospital. Medicare uses the national readmission rate to help decide what appropriate rates for each hospital, so to reduce their fines from previous years or avoid them altogether, hospitals must not only reduce their readmission rates but do so better than the industry did overall."

The source you've cited is from October, 2014. Has there been an update?

 

[dblack]

Many don't remember the huge hit hospitals took under Ronnie Ray-Gun's socialist EMTALA. The US no longer has burn units, trauma centers and many clinics and hospitals have closed. Professional staff have taken huge cuts in pay and benefits.

We should repeal stupid laws rather than pass more stupid laws to "compensate".

 

[Arianrhod]

Many don't remember the huge hit hospitals took under Ronnie Ray-Gun's socialist EMTALA. The US no longer has burn units, trauma centers and many clinics and hospitals have closed. Professional staff have taken huge cuts in pay and benefits.

We should repeal stupid laws rather than pass more stupid laws to "compensate".

Now if only everyone shared your definition of "stupid laws," what a wonderful world it would be.

 

[Sun Devil 92]

Hospitals could save a lot of money if we allowed them to turn away people at the ER.

Medicare already fines hospitals millions for what they deem "unnecessary" treatment....so why not.

Agreed.

If government is going to stick it's nose in the middle of medical care why don't they do it the right way.

 

[Sun Devil 92]

Many don't remember the huge hit hospitals took under Ronnie Ray-Gun's socialist EMTALA. The US no longer has burn units, trauma centers and many clinics and hospitals have closed. Professional staff have taken huge cuts in pay and benefits.

We should repeal stupid laws rather than pass more stupid laws to "compensate".

Stupid people don't know what stupid laws are.

That's why they flock to people like Obama who give them verbal handjobs and make them feel all warm and fuzzy....and numb enough not to notice the knife that just entered their backs.

 

[Sun Devil 92]

Hospitals could save a lot of money if we allowed them to turn away people at the ER.

They can also save a lot of money if they get to people before they show up in the ER, as Maryland is showing. Once hospitals can generate margin by keeping people healthy instead of increasing service volume, they've got a whole new business model to operate under. One in which health care isn't just about waiting for acute events to hit and making money off them, but rather about focusing on the health of the community outside the hospital's walls.

If I could laugh any harder I would.

Hospitals are only getting those who can afford to go there to begin with.

When your deductible is to high....you don't go.

So, it's great that Obamacare has weeded out people and marked them for "no care" instead of worrying about the quality of care.

 

[dblack]

Many don't remember the huge hit hospitals took under Ronnie Ray-Gun's socialist EMTALA. The US no longer has burn units, trauma centers and many clinics and hospitals have closed. Professional staff have taken huge cuts in pay and benefits.

We should repeal stupid laws rather than pass more stupid laws to "compensate".

Now if only everyone shared your definition of "stupid laws," what a wonderful world it would be.

And we have that agreement. I'm talking about EMTALA - which everyone seems to agree was a bad law.

 

[Arianrhod]

Many don't remember the huge hit hospitals took under Ronnie Ray-Gun's socialist EMTALA. The US no longer has burn units, trauma centers and many clinics and hospitals have closed. Professional staff have taken huge cuts in pay and benefits.

We should repeal stupid laws rather than pass more stupid laws to "compensate".

Now if only everyone shared your definition of "stupid laws," what a wonderful world it would be.

And we have that agreement. I'm talking about EMTALA - which everyone seems to agree was a bad law.

It was a Band-aid on a desperate situation. An inexcusable situation, one might argue, in the Best Damn Country in the World™.

Why is it "I love my country...I just hate most of the people in it"?

 

[Greenbeard]

If I could laugh any harder I would.

What business model would that be....nanny hospital ?

The bitterness is a little puzzling. Maryland's experimenting with ways to help their hospitals improve health and save money doing it. So far they seem to be succeeding. Does that make you angry?

Anyway, the answer to how they're changing their business models is in the OP: Global budgets pushing Maryland hospitals to target population health.

 

[Correll]

If I could laugh any harder I would.

What business model would that be....nanny hospital ?

The bitterness is a little puzzling. Maryland's experimenting with ways to help their hospitals improve health and save money doing it. So far they seem to be succeeding. Does that make you angry?

Anyway, the answer to how they're changing their business models is in the OP: Global budgets pushing Maryland hospitals to target population health.

Hospital stays have already been dramatically reduced.

I'm suspicious that there can be a lot more savings there without affecting patient care.

 

[Sun Devil 92]

If I could laugh any harder I would.

What business model would that be....nanny hospital ?

The bitterness is a little puzzling. Maryland's experimenting with ways to help their hospitals improve health and save money doing it. So far they seem to be succeeding. Does that make you angry?

Anyway, the answer to how they're changing their business models is in the OP: Global budgets pushing Maryland hospitals to target population health.

You only continue to talk in circles.

This is a reduction in the number of people who mooched off the ER by getting an 800K grant and then checking what kind of mattress they live on.

That means nothing to those who gotten to the point they can't afford to use their insurance. A point you continue to avoid.

Let me say it again: People can't afford to use their insurance.

Need it again...let me know.

Do I really want a doctor checking out my house ? F**k no.

 

[Sun Devil 92]

If I could laugh any harder I would.

What business model would that be....nanny hospital ?

The bitterness is a little puzzling. Maryland's experimenting with ways to help their hospitals improve health and save money doing it. So far they seem to be succeeding. Does that make you angry?

Anyway, the answer to how they're changing their business models is in the OP: Global budgets pushing Maryland hospitals to target population health.

Hospital stays have already been dramatically reduced.

I'm suspicious that there can be a lot more savings there without affecting patient care.

Yep reduced...like people are getting better....

What a statistical handjob.

 

[Sun Devil 92]

Many don't remember the huge hit hospitals took under Ronnie Ray-Gun's socialist EMTALA. The US no longer has burn units, trauma centers and many clinics and hospitals have closed. Professional staff have taken huge cuts in pay and benefits.

We should repeal stupid laws rather than pass more stupid laws to "compensate".

Now if only everyone shared your definition of "stupid laws," what a wonderful world it would be.

And we have that agreement. I'm talking about EMTALA - which everyone seems to agree was a bad law.

Agreed.

But Harvard said so many people were dying though they could not produce the corpses.

Never let a good heart wrenching crisis go to waste in an effort to create a lot more of them.

 

[Arianrhod]

If I could laugh any harder I would.

What business model would that be....nanny hospital ?

The bitterness is a little puzzling. Maryland's experimenting with ways to help their hospitals improve health and save money doing it. So far they seem to be succeeding. Does that make you angry?

Anyway, the answer to how they're changing their business models is in the OP: Global budgets pushing Maryland hospitals to target population health.

You only continue to talk in circles.

This is a reduction in the number of people who mooched off the ER by getting an 800K grant and then checking what kind of mattress they live on.

That means nothing to those who gotten to the point they can't afford to use their insurance. A point you continue to avoid.

Let me say it again: People can't afford to use their insurance.

Need it again...let me know.

Do I really want a doctor checking out my house ? F**k no.

Are you on Medicare?