NQF study on read­mis­sions isn’t about qual­ity im­prove­ment

Modern Healthcare - - COMMENT -

Re­gard­ing “NQF to study so­ciode­mo­graphic fac­tors in 30-day read­mis­sions” (ModernHealth­care.com, July 24), I find it ironic and more than a lit­tle telling that the mo­ti­va­tion be­hind this study is not to ac­tu­ally im­prove qual­ity of care. It’s to prove to the CMS that safety net hos­pi­tals are “dis­ad­van­taged” if held to the same read­mis­sions stan­dards used for every­one else, and de­serve an ad­just­ment that en­sures that they don’t lose rev­enue in the larger ef­fort to im­prove the qual­ity of care. In­ter­est­ingly, that’s pretty much the same ar­gu­ment made by many in­ter-city school dis­tricts, and largely for the same rea­son.

It’s also re­in­force­ment for the power of money to shape be­hav­ior. Spend fed­eral funds to pay for ser­vices with­out any real qual­ity con­tin­gency, and you get pro­vi­sion of ser­vices that are not tai­lored to the mar­ket­place. Medi­ocre re­sults fol­low.

It’s all too pre­dictable in the con­text of a mind­set that thinks more govern­ment reg­u­la­tion and more money is the an­swer to ev­ery prob­lem. What we need is to hold all providers ac­count­able to the same stan­dards, and find ways to em­power pa­tients to go to providers who meet and ex­ceed those stan­dards.

Michael Abrams

Man­ag­ing part­ner

Numerof & As­so­ciates

St. Louis

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