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Tuesday, March 5, 2013

Hospitals Starting to Profit from Patient Health, Not Sickness

Amy Traver

Staff Writer

The goal of our health care system is to keep us all healthy. So it’s not outrageous to think that doctors and hospitals would be paid for meeting this goal, right?


Until recently, hospitals have had no financial incentive to keep patients from returning. In fact, hospitals have historically made money every time a patient is admitted. If it sounds wacky, that’s because it is: Hospitals actually profited from keeping patients sick!

Thankfully, the Affordable Care Act is changing this. The law included a provision to reduce Medicare payments to hospitals with high preventable readmissions rates. This means that hospitals will now lose money every time a patient comes back within 30 days due to a preventable complication. So, hospitals now have a financial reason to ensure their patients stay healthy after they leave the hospital. Thanks to this policy in the Affordable Care Act and other new payment reforms, hospitals are finally starting to change their business models to profit from patient health, rather than patient sickness.

One way hospitals are starting to do this is by taking a more active role in helping patients manage their medications post-discharge. When patients leave the hospital, it can be hard for them to remember when and how to take medications they were prescribed. And this is especially true for patients taking many different medications to address chronic illnesses and multiple diseases. Because of this, medication errors can result in these patients ending up right back in the hospital only a few weeks later. Medication management can ensure that patients don’t return due to medication errors. Medication management involves monitoring the medications patients take to both confirm that the patient understands and complies with a medication regimen and avoids potentially dangerous drug interactions and complications.

Now that hospitals stand to gain from investing in their patients’ health outside of the hospital, they have a reason to make sure medication management services are available to patients in their community. Some hospitals are hiring care coordinators and patient educators to help patients understand their various medications and to prevent possible complications of straying from the recommended regimen. Other hospitals have started to partner with big-name drugstores, like Walgreens and CVS Caremark, that have created new programs  focused on following up with patients and making sure they understand their new medications and are able to take them when they get home.

Withholding Medicare payments for preventable readmissions is just one policy that will give hospitals a reason to invest in programs, like medication management services, that keep patients healthy. Thanks to payment reforms like this one, we are starting to see a health care system that profits from patient health, not sickness. 

Hospitals Starting to Profit from Patient Health, Not Sickness | Families USA


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