And so it begins.

[theeedude]

Spoken like somebody that has no idea what a communist is.

Equal pay for quality and shoddy work. Trying to control individual actors instead of creating financial incentives and letting those actors act in their own self interest. That was a big part of communism. We don't need it in America, thank you very much.

 

[zinfamous]

Or to put it another way: Do you think the govt paying less to hospitals that need to improve is a good thing?

I agree with some sort of penalty for poor performers, but recognize that cutting funding is no way to get the improvement we seek. And the latter is the real objective here.

The rule and its application seem terribly simplistic to me. Perhaps it's only that the article mistakenly gives that impression.

Fern

I thought the conservative mantra was that "Throwing money at the problem never works."

...or is that only when it's convenient to make the argument?

Actually, I don't entirely disagree with you here, I'm just curious if conservatives can illuminate for me when their talking points should be taken as gospel, and when as farce.

 

[Hayabusa Rider]

I'm not arguing against understanding in favor of mindless regulation, I'm arguing for regulation that is easy to implement and is proven to be effective.

All the things you're talking about would require a much greater investment in staff, time, etc. It might be worth it, it might not. I'm certainly willing to entertain other solutions but literally nothing about them would dissuade me from implementing regulations such as these with a proven track record.

Much like with the ACA as a whole, you are using the perfect as the enemy of the good. No thanks.

Well how about this. Implement it on the condition that this not be left as it stands? I mean timely visitation and change to reflect a more thoughtful approach?

 

[Hayabusa Rider]

Equal pay for quality and shoddy work. Trying to control individual actors instead of creating financial incentives and letting those actors act in their own self interest. That was a big part of communism. We don't need it in America, thank you very much.

Spoken like a true 0.001 percenter!

 

[fskimospy]

Well how about this. Implement it on the condition that this not be left as it stands? I mean timely visitation and change to reflect a more thoughtful approach?

That seems perfectly reasonable to me! If there's a better way to do it I'm all for it. I think there are tons of things in the ACA that are incompletely done or poorly implemented. I sincerely hope that once people stop treating it like a totem that we can address things like this.

 

[theeedude]

http://www.bloomberg.com/news/2015-...s-to-change-how-u-s-pays-the-doctor-bill.html

The Obama administration will make historic changes to how the U.S. pays its annual $3 trillion health-care bill, aiming to curtail a costly habit of paying doctors and hospitals without regard to quality or effectiveness.

Starting next year Medicare, which covers about 50 million elderly and disabled Americans, will base 30 percent of payments on how well health providers care for patients, some of which will put them at financial risk based on the quality they deliver. By 2018, the goal is to put half of payments under the new system.

For doctors and health facilities, the system will tie tens, and then hundreds, of billions of dollars in payments to how their patients fare, rather than how much work a doctor or hospital does, lowering the curtain on Medicare’s system of paying line-by-line for each scan, test and surgery.

Awesome and long overdue.

 

[piasabird]

Hospitals are only good for overpriced tests and emergencies.

 

[Victorian Gray]

You have the quote wrong first off. And second, which sounds more Marxist? Dealing with what actually may be going wrong with these hospitals on an individual basis, or the one size fits all financial punishment?

Neither. Never read Marx?

 

[Matt1970]

Neither. Never read Marx?

Really? One of us is advocating the same monetary punishment be applied to all regardless of situation and one of us is advocating it needs to be determined on an individual basis. And which Marx would you be referring to because he wrote 23 books and co-wrote 4 more?

 

[Hayabusa Rider]

http://www.bloomberg.com/news/2015-...s-to-change-how-u-s-pays-the-doctor-bill.html


Awesome and long overdue.

Oh you are going to love what happens if this isn't done right.

 

[Hayabusa Rider]

That seems perfectly reasonable to me! If there's a better way to do it I'm all for it. I think there are tons of things in the ACA that are incompletely done or poorly implemented. I sincerely hope that once people stop treating it like a totem that we can address things like this.

Fair enough.

 

[nickqt]

How is this topic still going.

Medicaid also doesn't reimburse hospitals if a patient comes into the hospital without pressure ulcers (bedsores), but leaves with them.

We know how to stop the formation of pressure ulcers. Move the patient every 2 hours.

We know how to stop HIAs. Better hygiene (washing your hands).

If these hospitals want the $, they better implement better policies. And remember, this is about reimbursement. Hospitals don't go out and make decisions about hiring an adequate number of competent nurses because Medicaid just throws them a check on January 1st.

 

[Zstream]

I have to say I'm amazed that conservatives are arguing for the government to pay the same (or even more!) to hospitals that deliver a poor product.





It's hard to imagine what the government could do other than impose some sort of financial penalty for bad performance. Hospital acquired infections are the very definition of waste in health care.

Do you even know what you're talking about? There are many cases the government isn't charged at all or should I say the taxpayer because they found an issue in the billing statement totally unrelated to the work performed? This is why many doctors refuse to care for those on Medicare or Medicaid. You have no idea lowly internet warrior..

 

[Zstream]

How is this topic still going.

Medicaid also doesn't reimburse hospitals if a patient comes into the hospital without pressure ulcers (bedsores), but leaves with them.

We know how to stop the formation of pressure ulcers. Move the patient every 2 hours.

We know how to stop HIAs. Better hygiene (washing your hands).

If these hospitals want the $, they better implement better policies. And remember, this is about reimbursement. Hospitals don't go out and make decisions about hiring an adequate number of competent nurses because Medicaid just throws them a check on January 1st.

You're completely wrong but its funny watching you try to explain the health industry.

 

[fskimospy]

Do you even know what you're talking about? There are many cases the government isn't charged at all or should I say the taxpayer because they found an issue in the billing statement totally unrelated to the work performed? This is why many doctors refuse to care for those on Medicare or Medicaid. You have no idea lowly internet warrior..

Is this rambling supposed to be relevant to the topic at hand?

I have empirical data that backs me up, as someone who thinks he knows what he's talking about, let's see yours.

 

[Zstream]

Is this rambling supposed to be relevant to the topic at hand?





I have empirical data that backs me up, as someone who thinks he knows what he's talking about, let's see yours.

Did you read your data? It has nothing to do with Medicare or Medicaid billing losses by hospitals. I don't care about the ACA as those clients utilize already existing health care providers that aren't government owned. http://www.aha.org/content/13/hospbill-explain.pdf

 

[fskimospy]

Did you read your data? It has nothing to do with Medicare or Medicaid billing losses by hospitals. I don't care about the ACA as those clients utilize already existing health care providers that aren't government owned. http://www.aha.org/content/13/hospbill-explain.pdf

I honestly have no clue how what you're talking about is relevant to the conversation.

 

[Zstream]

I honestly have no clue how what you're talking about is relevant to the conversation.

Because you don't have any idea of what it takes to fix the healthcare industry, in fact most here can't speak coherently on the topic. The only thing you seem to care about is enacting super liberal policies regardless of the repercussions.

The simple fact that hospitals lose money for Medicare and Medicaid are a telling sign that we're in a bad state. For the government to pay even less, is not only egregious but typical of a government run program.

Why isn't the question: How can we improve the billing and cost of the solution? Answer: You can't, there isn't enough money in the system to pay to support the labor cost. While you sit here accusing a hospital of negligence, you willingly overlook the cost/labor to support the healthcare industry that the government simply refuses to pay for.

 

[fskimospy]

Because you don't have any idea of what it takes to fix the healthcare industry, in fact most here can't speak coherently on the topic. The only thing you seem to care about is enacting super liberal policies regardless of the repercussions.

The simple fact that hospitals lose money for Medicare and Medicaid are a telling sign that we're in a bad state. For the government to pay even less, is not only egregious but typical of a government run program.

Why isn't the question: How can we improve the billing and cost of the solution? Answer: You can't, there isn't enough money in the system to pay to support the labor cost. While you sit here accusing a hospital of negligence, you willingly overlook the cost/labor to support the healthcare industry that the government simply refuses to pay for.

What a joke. I would suggest you research the claims that doctors and hospitals 'lose money' on Medicare patients more thoroughly. You might be surprised at what you find. (hint: check into optimal resource utilization)

Regardless, doctors and hospitals are free to stop taking Medicare at any time. Participation is entirely voluntary.

The idea that we have a system that consumes 18% of our GDP and are somehow unable to find enough money in our system to duplicate the efforts of other developed nations that provide similar care at a fraction of the cost sounds like someone who is allowing ideology to overwhelm logic. Our system is grossly wasteful (labor costs being one of those!), and hospital acquired infections are the very definition of waste.

If you would care to dispute the empirical findings as to the efficacy of these programs that I linked earlier I'm open to hearing about it. If you're just going to rant about health care, no thanks.

 

[Zstream]

What a joke. I would suggest you research the claims that doctors and hospitals 'lose money' on Medicare patients more thoroughly. You might be surprised at what you find. (hint: check into optimal resource utilization)

Regardless, doctors and hospitals are free to stop taking Medicare at any time. Participation is entirely voluntary.

The idea that we have a system that consumes 18% of our GDP and are somehow unable to find enough money in our system to duplicate the efforts of other developed nations that provide similar care at a fraction of the cost sounds like someone who is allowing ideology to overwhelm logic. Our system is grossly wasteful (labor costs being one of those!), and hospital acquired infections are the very definition of waste.

If you would care to dispute the empirical findings as to the efficacy of these programs that I linked earlier I'm open to hearing about it. If you're just going to rant about health care, no thanks.

My opinion is informed by factual data, the data you represented is absolutely nothing with what is being stated. You're lack of real world experience on the topic just proves to me what I've been stating all along.

This article shows the ignorance that you're displaying. It's mind numbing how bad you're at business.

http://www.slate.com/blogs/moneybox...ls_lose_money_treating_medicare_patients.html

Healthcare margins:

http://www.hfma.org/Content.aspx?id=16462

http://www.aha.org/content/00-10/05fragilehosps.pdf

http://www.forbes.com/sites/aroy/2011/09/21/medpac-64-of-hospitals-lose-money-on-medicare-patients/

http://www.healthleadersmedia.com/content/MAG-259987/Can-Hospitals-Break-Even-with-Medicare

You're profound lack of business acclimate means the people (ACA now) will be the ones paying for the cheap government insurance plans. Well.. I guess it's all on the taxpayer anyways.

 

[fskimospy]

My opinion is informed by factual data, the data you represented is absolutely nothing with what is being stated. You're lack of real world experience on the topic just proves to me what I've been stating all along.

This article shows the ignorance that you're displaying. It's mind numbing how bad you're at business.

http://www.slate.com/blogs/moneybox...ls_lose_money_treating_medicare_patients.html

Healthcare margins:

http://www.hfma.org/Content.aspx?id=16462

http://www.aha.org/content/00-10/05fragilehosps.pdf

http://www.forbes.com/sites/aroy/2011/09/21/medpac-64-of-hospitals-lose-money-on-medicare-patients/

http://www.healthleadersmedia.com/content/MAG-259987/Can-Hospitals-Break-Even-with-Medicare

You're profound lack of business acclimate means the people (ACA now) will be the ones paying for the cheap government insurance plans. Well.. I guess it's all on the taxpayer anyways.

Lol. Your slate article backs up my point. You are also not addressing the point of the thread or any of the empirical data provided so far in topic, which is the efficacy of differential payments based on hospital acquired infection rates.

You picked a tangent that no one was discussing and furiously argued against it. The links you supplied to fight this imaginary tangent are a mix of ones that support what I'm saying and advocacy pieces. Not only do you not seem to be familiar with the literature on the subject, you appear to have a problem reading your own links.

If you're going to rant about a tangent nobody is talking about at least be sure you have your facts straight.

 

[OverVolt]

How is this topic still going.

Medicaid also doesn't reimburse hospitals if a patient comes into the hospital without pressure ulcers (bedsores), but leaves with them.

We know how to stop the formation of pressure ulcers. Move the patient every 2 hours.

We know how to stop HIAs. Better hygiene (washing your hands).

If these hospitals want the $, they better implement better policies. And remember, this is about reimbursement. Hospitals don't go out and make decisions about hiring an adequate number of competent nurses because Medicaid just throws them a check on January 1st.

So then what is the explanation for why the law, in practice as oppose to in theory, has thus far punished hospitals who serve sicker/poorer communities? Is it the hospitals fault they have high numbers of immuno compromised or MRSA carrier admissions?

Not all patients are equal and you guys act like handwashing compliance at hospitals is low. It is not, its nearly 100% at every hospital, even the ones being punished. Nurses, as luck would have it, have all taken microbiology.

Considering that reimbursement is being determined by surveys I'd love to hear the excuse for why the swankiness or nice-looking-ness of a hospital is affecting the surveys. Some hospitals are old, some hospitals are new. In many cases it can't be helped.

 

[nickqt]

You're completely wrong but its funny watching you try to explain the health industry.

Show me where I said anything wrong.

I'll wait.

Good luck!

So then what is the explanation for why the law, in practice as oppose to in theory, has thus far punished hospitals who serve sicker/poorer communities? Is it the hospitals fault they have high numbers of immuno compromised or MRSA carrier admissions?

Not all patients are equal and you guys act like handwashing compliance at hospitals is low. It is not, its nearly 100% at every hospital, even the ones being punished. Nurses, as luck would have it, have all taken microbiology.

Considering that reimbursement is being determined by surveys I'd love to hear the excuse for why the swankiness or nice-looking-ness of a hospital is affecting the surveys. Some hospitals are old, some hospitals are new. In many cases it can't be helped.

MRSA infections almost always start inside the hospital. The infections almost always start because of lack of hygiene when performing an invasive action, such as inserting/cleaning/removing a catheter.

And handwashing compliance is far from being 99% at almost any hospital.

Yes, I intimately know that nurses have taken microbiology. It doesn't change the fact that knowledge of bacteria isn't the same as consistently and effectively washing your hands.

About the swankiness. A clean hospital will look clean, regardless of age or fancy curtains. A dirty hospital will look dirty, regardless of fancy curtains.

Ultimately, again, Medicaid doesn't just write a big check and then send it to a hospital for that hospital to make hiring and policy decisions. They pay bills.

If a hospital wants to keep receicing Medicaid, then they need to follow the rules and provide a certain quality of healthcare outcomes.

Which is just the same as if they want to get paid by a private health insurance company. Don't provide the level of care, don't follow the pre-established rules, and don't document things correctly, and they don't get compensated.

 

[theeedude]

So then what is the explanation for why the law, in practice as oppose to in theory, has thus far punished hospitals who serve sicker/poorer communities? Is it the hospitals fault they have high numbers of immuno compromised or MRSA carrier admissions?

Not all patients are equal and you guys act like handwashing compliance at hospitals is low. It is not, its nearly 100% at every hospital, even the ones being punished. Nurses, as luck would have it, have all taken microbiology.

Considering that reimbursement is being determined by surveys I'd love to hear the excuse for why the swankiness or nice-looking-ness of a hospital is affecting the surveys. Some hospitals are old, some hospitals are new. In many cases it can't be helped.

The sense of entitlement to taxpayer dollars is palpable, and cheered on by the Republicans, if it comes from business circles.
If you have a high number of sicker patients, you should be even more on top of preventable hospital acquired infections, not less.

 

[Fern]

I thought the conservative mantra was that "Throwing money at the problem never works."

...or is that only when it's convenient to make the argument?

Actually, I don't entirely disagree with you here, I'm just curious if conservatives can illuminate for me when their talking points should be taken as gospel, and when as farce.

I never suggested we "throw money" at the problem. How questioning whether cutting the already low Medicare fees is the best solution morphs into "throwing money" escapes me.

Fern