Healthcare Reform Is Changing Medical Professional Liability - Are you ready?
July 03, 2012| By Joe Meli | Professional Liability | English
The U.S. healthcare system is in the middle of the most significant change in its history. The Affordable Care Act and similar private initiatives will result in shifting loss exposures, new areas of liability, and changes in the frequency and severity of losses.
In this uncertain environment the winners will be those who follow events closely, understand how the changes will impact their business, and then react to them in a in a prudent manner.
The New England Journal of Medicine recently published a study on the link between hospital based “pay-for-performance programs” and actual patient outcomes. The study focused on the fact that pay-for-performance is a centerpiece in the overall strategy to improve healthcare while improving efficiency (e.g., eliminating waste). By paying hospitals bonuses for meeting benchmarks (or penalties for not meeting them), CMS and private payers hope to incent providers to cut costs, while improving the quality of care. The expected “savings” are intended to be shared, so the patients, providers, and payers all have an opportunity to “win.”
So, how is this strategy going? According to the study: Not very well.
“We found no evidence that the largest hospital-based pay-for-performance program led to a decrease in 30-day mortality. Expectations of improved outcomes for programs modeled after Premier HQID should therefore remain modest.”
While this is only one study, it underscores the inherent complexity involved with creating the mix of incentives and penalties that are needed to drive behaviors across all of the participants that participate in our medical system.
You can read the article The Long-Term Effect of Premier Pay for Performance on Patient Outcomes on the NEJM website.