Thursday, August 12, 2010

Surgical Warranties

The mathematics and specific details of this article from Archives elude me to a certain (substantial) extent, but the main gist of it is this:
Complications and costs of care can be indexed to quality performing hospitals. Warranties for surgical care can reward effective and efficient care and preclude the need for additional payments for complications.

What that means, I think, is that those providers and hospitals that perform colon surgery with a lower overall incidence of complications set the bar in terms of bundled payment reimbursements. Those hospitals with higher complication rates, and therefore accrue higher costs, will find that much of the cost of this additional care and treatment will go un-reimbursed; thereby financially incentivizing them to either do a better job taking out colons or to get out of the colectomy business altogether.

I don't have much of a problem with this, to the exent that it is implemented fairly. A small hospital that recruits a colorectal surgeon isn't going to have the numbers to compete with the big tertiary care centers. As a result, complications that occur in the initial couple of years are going to statistically stand out as blaring clarion calls to cut reimbursements to that small hospital.

And the giant referral centers, teeming with surgical subspecialists clamoring for every square inch of operable human flesh will like that just fine.

1 comment:

j swift said...

The Human devolution agenda is so perfectly suited for avant garde medical journalism in this the holy land of imbeciles.(Mencken reference) I would never allow such crap to be published in any journal I edited but alas I am a purist. I would of course guarantee any surgery with the appropriate disclaimer that if a complication occurs the warranty does not apply. This type of article seems to be yet another carefully practiced symptom of a failed financial(Ponzi)system malingering as a private medical system.