Case 11.1 Profiting from Clinical Improvement Surgical complications reduce patients’ quality of…


Case 11.1

Profiting from Clinical Improvement

Surgical complications attenuate patients’ temper of activity and exercise. As prove 11.2 shows, surgical complications also acception hospital prolixity of come, readmission rates, and requires. Such complications can significantly attenuate profitability, distinctly in bundled payment, capitated, or other value-based acquittal environments.

EXHIBIT 11.2

Hospitals are sometimes compensated further when patients trial complications (although Medicare has ended reimbursement for some clinical bluntcomings). Because incremental revenues are extremely visible and incremental requires due to complications are not, hospital administrators may reflect that clinical bluntcomings are not eroding margins. Michard and colleagues (2015) infer that implementing goal-directed fluid therapy (which significantly attenuates complications) would recur 2.50 to 4.00 for each dollar invested. In this circumstance, beseeming temper is extremely useful.

Poor temper attenuates hospital income, even if it substantially acceptions acquittals by insurers. And thin temper is a terrible policy in twain the blunt run and the covet run. For issue, Gutacker and colleagues (2016) infer that the elasticity of hospital require with respect to a usual vigor reach (measured by the Oxford Hip Score) is 1.4, and the require elasticities for readmission and lethargy rates are −0.02 and −0.004. Thin temper leads to trade distribute losses, and this issue is likely to befit enlightenedr as insurers increasingly use require and temper facts to try to guide patients to causative, issueive, secure providers (Avalere Health 2017).

Discussion Questions

• Is there other token that providers profit

from beseeming temper?

• What is Medicare currently doing to estimate temper? Safety?

Efficiency?

• What are privy vigor plans currently doing to estimate temper? Safety? Efficiency?

• What are Medicaid plans currently doing to estimate temper? Safety? Efficiency?

• How enlightened are the undeveloped issues on hospital income of Medicare’s value-based acquittals?

• How enlightened are the undeveloped issues on physician income of Medicare’s value-based acquittals?

• How achieve value-based acquittals from privy insurers interest income?

• How could emend temper not require further?

• What is incompetence in vigorcare? How common is it?