Texas above na­tional av­er­age

Hos­pi­tals

Austin American-Statesman - - THE SECOND FRONT - Con­tin­ued from A HOSPI­TAL QUAL­ITY/SAT­IS­FAC­TION BONUSES, PENAL­TIES *In­cludes st. david’s Ge­orge­town Hospi­tal and Heart Hospi­tal of austin source: Kaiser Health news Con­tact Mary Ann Roser at 445-3619.

30 per­cent, said David Thom­sen, vice pres­i­dent of qual­ity at St. David’s.

Hospi­tal qual­ity is judged on 12 items, in­clud­ing whether heart at­tack pa­tients re­ceived medicine to pre­vent blood clots and whether pa­tients who had surgery or pneu­mo­nia re­ceived the cor­rect an­tibi­otics. Sat­is­fac­tion is gauged by pa­tient re­sponses to eight ques­tions, in­clud­ing whether the staff com­mu­ni­cated in­struc­tions well and how well pain was con­trolled.

Although pub­lic hos­pi­tals tend to do worse, the pub­lic Univer­sity Med­i­cal Cen­ter Brack­en­ridge, run by Se­ton, will re­ceive a bonus for its pa­tient qual­ity and sat­is­fac­tion scores.

Of­fi­cials at both Se­ton and St. David’s said they strongly sup­port the fed­eral scor­ing pro­gram.

“It’s work­ing, and it’s great for pa­tients,” Thom­sen said. “It’s cre­ated this won­der­ful di­a­logue across the coun­try.”

The pro­gram will help con­sumers com­pare hos­pi­tals, said Lisa McGif­fert, di­rec­tor of the Safe Pa­tient Project for Con­sumers Union.

“What’s help­ful to the pub­lic to know is the fed­eral government, as per the health re­form law, is giv­ing bonuses for the hos­pi­tals that do well in their qual­ity and safety mea­sures and assess­ing penal­ties on hos­pi­tals do­ing poorly,” McGif­fert said.

The government’s ef­forts to tie $1 bil­lion in Medi­care pay­ments to pa­tient qual­ity and sat­is­fac­tion come nearly three months af­ter the Cen­ters for Medi­care and Med­i­caid Ser­vices be­gan pe­nal­iz­ing hos­pi­tals for read­mit­ting pa­tients within 30 days of dis­charge.

Twelve Austin-area hos­pi­tals, in a list dom­i­nated by Se­ton, re­ceived smaller Medi­care pay­ments start­ing Oct. 1 be­cause of the rate of their read­mis­sions.

Se­ton an­tic­i­pates its losses on the lat­est qual­ity and sat­is­fac­tion mea­sures, which will take ef­fect New Year’s Day, to be “about half a mil­lion dol­lars,” spokes­woman Adri­enne Lallo said.

That is not much for Se­ton, and the re­sults were ex­pected, she said, adding that Se­ton takes se­ri­ously the goal of the pro­gram: im­prov­ing pa­tient care. Se­ton has started pro­grams that in­clude call­ing dis- Austin Sur­gi­cal Hospi­tal Cedar Park Re­gional Med­i­cal Cen­ter Cen­tral Texas Med­i­cal Cen­ter, San Mar­cos St. David’s North Austin Med­i­cal Cen­ter St. David’s Round Rock Med­i­cal Cen­ter Scott & White Hospi­tal-Round Rock Se­ton North­west Hospi­tal Se­ton Med­i­cal Cen­ter Austin Se­ton Med­i­cal Cen­ter Hays Se­ton Med­i­cal Cen­ter Wil­liamson Se­ton South­west Hospi­tal St. David’s Med­i­cal Cen­ter* St. David’s South Austin Med­i­cal Cente The Hospi­tal at West­lake Med­i­cal Cen­ter Univer­sity Med­i­cal Cen­ter Brack­en­ridge charged pa­tients at home to re­mind them to take their medicine, and it has opened a clinic to give at­ten­tion to con­ges­tive heart fail­ure pa­tients, Lallo said.

St. David’s prob­a­bly will get “hun­dreds of thou­sands of dol­lars” in bonuses, Thom­sen said, but amounts aren’t known be­cause they are based on how many Medi­care pa­tients the hos­pi­tals treats be­tween the be­gin­ning of the year and Sept. 30, he said.

Na­tion­wide, Medi­care judged 2,984 hos­pi­tals, in­clud­ing 251 in Texas, ac­cord­ing to the Kaiser anal­y­sis. Texas hos­pi­tals did bet­ter than the na­tional av­er­age, with 66 per­cent get­ting bonuses and 34 per­cent be­ing pe­nal­ized in com­par­i­son with a na­tional av­er­age of 52 per­cent get­ting bonuses and 48 per­cent get­ting dinged, ac­cord­ing to Kaiser.

The most any hospi­tal could gain or lose is 1 per­cent of its Medi­care pay­ments, but those per­cent­ages will in­crease an­nu­ally. For nearly two-thirds of the na­tion’s hos­pi­tals, the changes are less than a quar­ter of a per­cent of their pay­ments, Kaiser said.

Cen­tral Texas Med­i­cal Cen­ter was dis­ap­pointed by the re­sults, although 0.39% -0.04% -0.08% 0.41% 0.26% 0.35% -0.01% -0.03% 0.35% 0.21% 0.22% 0.31% 0.33% 0.38% 0.18% the fi­nan­cial ef­fect is min­i­mal, said spokesman Clay DeStefano. “In the last year alone, CTMC re­ceived sev­eral qual­ity achieve­ment awards from a va­ri­ety of sources on th­ese very mea­sures, which just shows how rapidly health care in­dus­try mea­sures — es­pe­cially those af­fect­ing re­im­burse­ments — are chang­ing,” he said.

Cedar Park Re­gional Med­i­cal Cen­ter has taken var­i­ous steps to im­prove pa­tient care, said spokes­woman Laura Balla, in­clud­ing iden­ti­fy­ing pa­tients at the high­est risk for read­mis­sion and ed­u­cat­ing pa­tients to bet­ter take care of them­selves af­ter they are dis­charged.

The Texas De­part­ment of State Health Ser­vices this month has posted hospi­tal-ac­quired in­fec­tion data for the first half of this year on­line at txhsn.dshs.texas.gov/hai for cer­tain con­di­tions, but most Cen­tral Texas hos­pi­tals’ per­for­mance was av­er­age or they did not have enough data to report.

The Kaiser anal­y­sis is avail­able at kaiser­health­news.org/Sto­ries/2012/ De­cem­ber/21/medi­care­hos­pi­tals-value-based­pur­chas­ing.aspx.

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