Billion-Dollar Hospital Bonuses Not Seen Improving Health

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http://www.bloomberg.com/news/2013-01-25/billion-dollar-hospital-bonuses-not-seen-improving-health.html

The chief executive officer of an HCA-owned (HCA) hospital recently went undercover, wearing a two-day- old beard and a baseball cap to pose as a patient entering his hospital. His goal: spot service flaws and get them fixed.

The covert mission was part of a bid to win some of the almost $1 billion in government payments for hospitals with top ranked service. Across the U.S., the program is encouraging tidier rooms and quieter hallways at the more than 3,000 hospitals that participate in “patient experience” surveys.

As welcome as those improvements may be, numerous studies based on earlier attempts to tie bonuses to performance suggest such incentives may do little to improve care. Rewarding hospitals based on patient’s experience could also have unforeseen repercussions, doctors and economists say. Such incentives, for example, may harm patients most in need of care by discouraging hospitals from treating the elderly and the mentally ill, they say. Hospitals also have concerns.

“Patients who are critically ill, they’re less likely to rate hospitals as highly as those going home with a healthy newborn,” Nancy Foster, vice president for quality and patient safety policy at the American Hospital Association, the industry’s main lobby group, said in an interview.