Tying Medicare Payment to Quality

[Greenbeard]

The baby steps toward getting better value for our dollar continue via some of the new Medicare reforms:

In mid-December, the Centers for Medicare & Medicaid Services (CMS) posted one of the most important steps we’ve taken yet for Medicare reform. [...]

The Hospital Value-Based Purchasing Program is one of a host of Affordable Care Act programs that put patients at the center of the Medicare system. We’ve known for a long time that when Medicare paid providers based on how much work they did and not on how well they did for patients, too often patients got services and tests that didn’t improve their health. Providers already must publicly report the steps they take to provide quality care to Medicare beneficiaries; Hospital Value-Based Purchasing gives these efforts additional teeth.

Beginning in 2013, Medicare will start paying hospitals a little more or a little less in each payment depending on how well they meet Medicare’s quality standards. The value-based payment adjustment factors tell them how much their base Medicare payments will change.

Hospitals are graded on improvement as well as performance on a variety of quality measures. These standards are consistent with clinical practice for the provision of high quality care. Did emergency room staff follow the right protocols with a heart-attack patient? Did a patient get antibiotics before surgery? Did your nurses and doctors listen to you?

In the next few years, as payment incentives gradually increase and more quality measures are added to the program, we will continue working with hospitals to make sure Medicare beneficiaries’ quality of care improves. The Hospital Value-Based Purchasing program is off to a strong start. Posting the value-based payment adjustment factors may seem like a routine step, but it actually heralds a new era in which Medicare actively promotes the best care for beneficiaries and makes their health priority #1.

 

[Oddball]

Oh goody!....More bureaucrats and red tape!...That'll bring costs down!

 

[Greenbeard]

Indeed! Medicare cost growth continues to hover at record lows, as the bean counters at CBO have for the third year in a row had to admit that Medicare growth this year is "substantially lower" than their year-beginning estimates anticipated.


S&P's indices spot it, as well:

 

[dblack]

Oh goody!....More bureaucrats and red tape!...That'll bring costs down!

The main thing is to maintain centralized, authoritarian control over all aspects of our lives. Go Greenbeard!

 

[eflatminor]

The baby steps toward getting better value for our dollar

Right, because centrally planned price controls ALWAYS do a better job of that than does competition and individual choice....

God you're a nanny state suck up.

 

[CrusaderFrank]

LOLz

Democrats are such total fucking morons

Their economic "ideas" are being abandoned by real Communists

 

[CrusaderFrank]

Greenbeard's Government control of rice production in Vietnam sucked so bad that they had to import 2 million tons annually to keep people from starving.

They dropped that in favor of free enterprise, the way the US was before the Neo-Marxists took over and they are now prosperous and the second leading exporter of rice on the planet

 

[Greenbeard]

The baby steps toward getting better value for our dollar

Right, because centrally planned price controls ALWAYS do a better job of that than does competition and individual choice....

Medicare beneficiaries do have individual choice of hospitals, as it's extremely rare for a hospital not to accept Medicare (Medicare and Medicaid together make up a majority of hospital volume in the U.S.). They can vote with their feet as much as anyone choosing a hospital can. For a variety of reasons, which may or may not be obvious to you, that alone does not promote quality or continuous quality improvement.

It's long past time for pay to reflect performance, if only to a small degree at first.

 

[eflatminor]

Medicare beneficiaries do have individual choice of hospitals...

Do I have a choice to but to pay for these people? Didn't think so. Stick your central planning of markets. It ALWAYS results in skyrocketing prices shitty results.

 

[Greenbeard]

Medicare beneficiaries do have individual choice of hospitals...

Do I have a choice to but to pay for these people? Didn't think so. Stick your central planning of markets. It ALWAYS results in skyrocketing prices shitty results.

That seems to be the fundamental philosophical gap here: I'm starting from the presumption that the goal of our health sector, and in particular here our hospitals, should be to treat and heal the sick or injured to the best of that sector's abilities and be appropriately and adequately compensated for it. Thus finding ways to do that better is not only a necessary and admirable pursuit, it's cause for celebration when progress is made.

A common alternative formulation seems to be that the goal of the health sector should be to avoid treating or healing the sick or injured to the maximum extent possible. If that's the worldview you start from then obviously pursing higher quality care at lower cost is not going to be of much interest.

 

[CrusaderFrank]

Medicare beneficiaries do have individual choice of hospitals...

Do I have a choice to but to pay for these people? Didn't think so. Stick your central planning of markets. It ALWAYS results in skyrocketing prices shitty results.

That seems to be the fundamental philosophical gap here: I'm starting from the presumption that the goal of our health sector, and in particular here our hospitals, should be to treat and heal the sick or injured to the best of that sector's abilities and be appropriately and adequately compensated for it. Thus finding ways to do that better is not only a necessary and admirable pursuit, it's cause for celebration when progress is made.

A common alternative formulation seems to be that the goal of the health sector should be to avoid treating or healing the sick or injured to the maximum extent possible. If that's the worldview you start from then obviously pursing higher quality care at lower cost is not going to be of much interest.

Quit fucking around. We know you do Goebbels work for ObamaCare, Eugenics Section.

You know your system has a 100% Fail Rate

We know your system has a 100% Fail Rate

It's failed in China, Russia, Vietnam and even Cuba has humped and dumped your stupid central planned system.

 

[boedicca]

The OP is a lie. The Hospital Value-Based Purchasing Program doesn't put the Patients at the center of the Medicare system. That would be impossible as Government occupies that position.

 

[eflatminor]

...it's cause for celebration when progress is made.

Not when free people making voluntary choices provides vastly superior results...and do so without stealing from anyone.

 

[CrusaderFrank]

The baby steps toward getting better value for our dollar continue via some of the new Medicare reforms:

In mid-December, the Centers for Medicare & Medicaid Services (CMS) posted one of the most important steps we’ve taken yet for Medicare reform. [...]

The Hospital Value-Based Purchasing Program is one of a host of Affordable Care Act programs that put patients at the center of the Medicare system. We’ve known for a long time that when Medicare paid providers based on how much work they did and not on how well they did for patients, too often patients got services and tests that didn’t improve their health. Providers already must publicly report the steps they take to provide quality care to Medicare beneficiaries; Hospital Value-Based Purchasing gives these efforts additional teeth.

Beginning in 2013, Medicare will start paying hospitals a little more or a little less in each payment depending on how well they meet Medicare’s quality standards. The value-based payment adjustment factors tell them how much their base Medicare payments will change.

Hospitals are graded on improvement as well as performance on a variety of quality measures. These standards are consistent with clinical practice for the provision of high quality care. Did emergency room staff follow the right protocols with a heart-attack patient? Did a patient get antibiotics before surgery? Did your nurses and doctors listen to you?

In the next few years, as payment incentives gradually increase and more quality measures are added to the program, we will continue working with hospitals to make sure Medicare beneficiaries’ quality of care improves. The Hospital Value-Based Purchasing program is off to a strong start. Posting the value-based payment adjustment factors may seem like a routine step, but it actually heralds a new era in which Medicare actively promotes the best care for beneficiaries and makes their health priority #1.

4 Goebbels for that one. Kass must love you

 

[rdean]

Do I have a choice to but to pay for these people? Didn't think so. Stick your central planning of markets. It ALWAYS results in skyrocketing prices shitty results.

That seems to be the fundamental philosophical gap here: I'm starting from the presumption that the goal of our health sector, and in particular here our hospitals, should be to treat and heal the sick or injured to the best of that sector's abilities and be appropriately and adequately compensated for it. Thus finding ways to do that better is not only a necessary and admirable pursuit, it's cause for celebration when progress is made.

A common alternative formulation seems to be that the goal of the health sector should be to avoid treating or healing the sick or injured to the maximum extent possible. If that's the worldview you start from then obviously pursing higher quality care at lower cost is not going to be of much interest.

Quit fucking around. We know you do Goebbels work for ObamaCare, Eugenics Section.

You know your system has a 100% Fail Rate

We know your system has a 100% Fail Rate

It's failed in China, Russia, Vietnam and even Cuba has humped and dumped your stupid central planned system.

Who knows what you are talking about? When you babble, you drool. One of these days, you are going to babble so much, you'll drown.

 

[CrusaderFrank]

That seems to be the fundamental philosophical gap here: I'm starting from the presumption that the goal of our health sector, and in particular here our hospitals, should be to treat and heal the sick or injured to the best of that sector's abilities and be appropriately and adequately compensated for it. Thus finding ways to do that better is not only a necessary and admirable pursuit, it's cause for celebration when progress is made.

A common alternative formulation seems to be that the goal of the health sector should be to avoid treating or healing the sick or injured to the maximum extent possible. If that's the worldview you start from then obviously pursing higher quality care at lower cost is not going to be of much interest.

Quit fucking around. We know you do Goebbels work for ObamaCare, Eugenics Section.

You know your system has a 100% Fail Rate

We know your system has a 100% Fail Rate

It's failed in China, Russia, Vietnam and even Cuba has humped and dumped your stupid central planned system.

Who knows what you are talking about? When you babble, you drool. One of these days, you are going to babble so much, you'll drown.

25% unemployment in Greece and Spain, but yes lets do more Democrat Central Planning here in the USA because 4 years at 8% is awesome sauce

 

[boedicca]

Quit fucking around. We know you do Goebbels work for ObamaCare, Eugenics Section.

You know your system has a 100% Fail Rate

We know your system has a 100% Fail Rate

It's failed in China, Russia, Vietnam and even Cuba has humped and dumped your stupid central planned system.

Who knows what you are talking about? When you babble, you drool. One of these days, you are going to babble so much, you'll drown.

25% unemployment in Greece and Spain, but yes lets do more Democrat Central Planning here in the USA because 4 years at 8% is awesome sauce

We're almost at 25%.

Alternate Unemployment Charts

 

[dblack]

That seems to be the fundamental philosophical gap here: I'm starting from the presumption that the goal of our health sector, and in particular here our hospitals, should be to treat and heal the sick or injured to the best of that sector's abilities and be appropriately and adequately compensated for it. Thus finding ways to do that better is not only a necessary and admirable pursuit, it's cause for celebration when progress is made.

A common alternative formulation seems to be that the goal of the health sector should be to avoid treating or healing the sick or injured to the maximum extent possible. If that's the worldview you start from then obviously pursing higher quality care at lower cost is not going to be of much interest.

This does get to the core of things, maybe even to an interesting discussion. The core philosophical difference is in our assumptions about the purpose of government. You pretty consistently stand up for the idea that it's government's job to decide what we should do and force us to do it. I prefer a government that preserves our freedom to pursue our own visions of the good life.

 

[CrusaderFrank]

That seems to be the fundamental philosophical gap here: I'm starting from the presumption that the goal of our health sector, and in particular here our hospitals, should be to treat and heal the sick or injured to the best of that sector's abilities and be appropriately and adequately compensated for it. Thus finding ways to do that better is not only a necessary and admirable pursuit, it's cause for celebration when progress is made.

A common alternative formulation seems to be that the goal of the health sector should be to avoid treating or healing the sick or injured to the maximum extent possible. If that's the worldview you start from then obviously pursing higher quality care at lower cost is not going to be of much interest.

This does get to the core of things, maybe even to an interesting discussion. The core philosophical difference is in our assumptions about the purpose of government. You pretty consistently stand up for the idea that it's government's job to decide what we should do and force us to do it. I prefer a government that preserves our freedom to pursue our own visions of the good life.

Greenbeard is a Party insider who is paid to post here and disseminate false information.

 

[dblack]

That seems to be the fundamental philosophical gap here: I'm starting from the presumption that the goal of our health sector, and in particular here our hospitals, should be to treat and heal the sick or injured to the best of that sector's abilities and be appropriately and adequately compensated for it. Thus finding ways to do that better is not only a necessary and admirable pursuit, it's cause for celebration when progress is made.

A common alternative formulation seems to be that the goal of the health sector should be to avoid treating or healing the sick or injured to the maximum extent possible. If that's the worldview you start from then obviously pursing higher quality care at lower cost is not going to be of much interest.

This does get to the core of things, maybe even to an interesting discussion. The core philosophical difference is in our assumptions about the purpose of government. You pretty consistently stand up for the idea that it's government's job to decide what we should do and force us to do it. I prefer a government that preserves our freedom to pursue our own visions of the good life.

Greenbeard is a Party insider who is paid to post here and disseminate false information.

I have no idea what the motivation is. I suppose that if the Party sees these message boards as influential it might be worth a few bucks to spam us. It's also possible he's just a die hard cheerleader for the authoritarian state. In either case, I don't really think he's posting false information. Outside the overly optimistic predictions of the law's impact, most of what GB posts is factually correct. There's plenty of spin and demagoguery thrown in for good measure, but that's hardly uncommon around here.