Medicare Changes May Hurt Hospitals for Poor
Medicare quality ratings and bonus payments, as a result of the 2010 health reform, are once again in the spotlight.
In March, we wrote about how a study found that publishing Medicare quality ratings for hospitals on the Hospital Compare website has had little to no effect on mortality rates in hospital. Then last month, we wrote about how the effectiveness of Medicare quality ratings for Medicare Advantage plans was being questioned by critics.
A recent study has shown that the change in payments to hospitals as a result of health reform and Medicare quality ratings may add to the financial problems faced by “safety net” hospitals.
What are safety net hospitals?
Safety net hospitals or health care systems provide care to low-income, uninsured, and vulnerable populations, as defined by the National Association of Public Hospitals and Health Systems. These hospitals are not defined by ownership, but rather by their commitment to provide access to those with limited or no access to healthcare due to extenuating circumstances.
In a recent study, published in the Archives of Internal Medicine, researchers found that safety net hospitals tend to score lower overall than other hospitals. Being in less urban areas and with less funding, these hospitals tend to have less staff support per patient. The gap has widened between the scores that safety hospitals receive from their patients compared to other hospitals. Their patients are likely to have more health complications and have less trust in the health care system, according to the study.
How do Medicare quality ratings affect hospitals for the poor?
Medicare once gave these types of hospitals additional financial support for providing care to the poor; however, with the introduction of these quality ratings, it is likely that safety net hospitals will receive less funding due to their low ratings. Safety net hospitals already receive lower reimbursement rates for mainly treating patients on government insurance or without any insurance at all.
However, these safety net hospitals are an important part of the health care system according to physicians and experts in the medical field. Some think that Medicare quality ratings add more pressure rather than help safety net hospitals focus on optimizing patient care.
In an editorial written by Dr. Katherine Neuhausen, a Los Angeles family physician, and Dr. Mitchell Katz, the director of the Los Angeles County of Public Health Services, they call out to the federal government to give more money to hospitals that perform well rather than penalizing those that do not.
Do you know of any safety net hospitals in your area? What do you think should be done to provide support and improve patient care at these hospitals?
Medicare has not reviewed or endorsed this information.