From last week’s Premier press release:
Hospital quality continues to improve while patient mortality rates and hospital costs are declining among participants in a Centers for Medicare and Medicaid Services (CMS) pay-for-performance (P4P) demonstration project, according to a recent analysis by the Premier healthcare alliance.
According to the analysis, the broadest of its kind, of 1.1 million patient records from participating Hospital Quality Incentive Demonstration (HQID) hospitals, if all hospitals nationally were to achieve the three-year cost and mortality improvements found among the HQID project participants for pneumonia, heart bypass, heart failure, heart attack (acute myocardial infarction), and hip and knee replacement patient populations, they could save an estimated 70,000 lives per year and reduce hospital costs by more than $4.5 billion annually. The 1.1 million patient records represented in this analysis encompass 8.5 percent of all patients nationally within the five noted clinical areas over the three-year timeline of this analysis.
There’s a ton of additional material on the Premier website, accessible at the link above.
I’ve written about the HQID demonstration before (here and here), and have highlighted questions regarding the long-term viability of P4P plans and improvements.
This demo has been focusing on improvements in both cost and quality metrics. Today, we’ve seen reports on a new study concluding that healthier folks ultimately consume more health care resources (because they live longer . . . ), theoretically upending the economic rationale for certain sorts of preventive care. CMS and other payors have been pursuing P4P experiments at least in part because of a desire to rein in health care spending; today’s study may throw a wrench in that calculus, perhaps requiring a social commitment to quality of care, and probably demanding a more explicit approach to rationing of scarce health care resources in the long run.
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