By Manish Mittal, Chih-Hsiung E. Wang, Abigail H. Goben, Andrew D. Boyd
PLOS ONE, Abstract, September 18, 2018
Reducing preventable readmissions among Medicare beneficiaries is an effective way to not only reduce the exorbitantly rising cost in healthcare but also as a measure to improve the quality of patient care. Many of the previous efforts in reducing readmission rate of patients have not been very successful because of ill-defined quality measures, improper data collection methods and lack of effective strategies based on data driven solutions.
In this study, we analyzed the readmission data of patients for six major diseases including acute myocardial infarction (AMI), heart failure (HF), coronary artery bypass graft (CABG), pneumonia (PN), chronic obstructive pulmonary disease (COPD), and total hip arthroplasty and/or total knee arthroplasty (THA/TKA) from the Center for Medicare and Medicaid Readmissions Reduction Program (HRRP) program for the period 2012–2015 in context with the ownership structure of the hospitals.
Our analysis demonstrates that the readmission rates of patients were statistically higher in proprietary (for profit) hospitals compared to the government and non-profit hospitals which was independent of their geographical distribution across all six major diseases.
This finding we believe has strong implications for policy makers to mitigate any potential risks in the quality of patient care arising from unintended revenue pressure in healthcare institutions.
From the Discussion
The policy makers need to carefully evaluate and design healthcare policies that mitigate potential risks associated with unintended revenue pressure in harming patients.
By Don McCanne, M.D.
Is the primary mission of the health care organization to serve the needs of patients, or is it to make a buck? It makes a difference. This study shows that readmission rates were higher in proprietary (for profit) hospitals than in non-profit hospitals.
This fundamental difference in hospitals that must cater to passive investors is one reason why the single payer, improved Medicare for all model as supported by Physicians for a National Health Program would covert for profit entities to non-profit. Unfortunately, this important policy recommendation is being left out of many of today’s discussions on health care reform.
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