Money for Mistakes?

Hospitals have historically been reimbursed based on fee for service; the more that happens to the patient in the hospital, the higher the reimbursement. So, do hospitals make more money off patient safety efforts, or off patients who suffer complications and injuries? A recent study suggests that it depends on the patient's insurance. In the latest JAMA, researchers found that patients with private insurance suffering 1 complication during a surgical procedure bring in $30,000 more than patients that do well and are discharged quickly. On the other hand, reimbursement only increased $2,000 with similar Medicare patients and it decreased with Medicaid patients. This is the rationale behind Medicare's efforts at cost saving via Value Based Purchasing, Hospital Acquired Conditions, and other programs, to reduce reimbursement for patients that suffer potentially preventable conditions, This study highlights the ongoing perverse financial "incentives" that can hinder patient safety efforts.