Hospitals Profit From Post Surgical Complications

Fierce Healthcare has;
Hospitals Profit From Post Surgical Complications

Profit margins for insured patients more than triple when complications occur

April 17, 2013 | By Julie Bird

Hospitals that reduce post-surgical complications could be cutting into their profits, concludes a study published yesterday in The Journal of the American Medical Association.

The study by The Boston Consulting Group, Texas Health Resources and Ariadne Labs found a 330 percent higher profit margin when insured surgical patients experienced a complication, according to an announcement of the findings. The margin increase for Medicare patients experiencing post-surgical complications totaled 190 percent.

"This clearly indicates that health care payment reform is necessary," study author Atul Gawande, M.D., a surgeon and a professor at Harvard School of Public Health, said in a statement. 

"It's been known that hospitals are not rewarded for quality, but it hadn't been recognized exactly how much more money they make when harm is done."

Study co-author Barry Rosenberg, M.D., a Chicago-based partner in the consulting group, was even more blunt: "The U.S. healthcare system is paying for harm," he noted, by "rewarding hospitals for complications."

Moreover, hospitals should not suffer financially for improving outcomes, added David Sadoff, another co-author from the consulting group.

The researchers examined costs related to more than 34,000 surgical inpatient procedures at a 12-hospital system in 2010, including 1,820 that involved complications.

"The magnitude of the numbers was eye-popping," Gawande said in an interview with NPR. "It was much larger than we expected."
It's not that hospitals are trying to cause complications, Gawande told NPR. "But we've seen a lot of hospitals where you say, 'Why aren't you investing in reducing risk, the way other industries do?' "

A similar study last year also found that eliminating surgical complications hurts hospitals' cash flow. Hospitals lose about $1.2 million in annual reimbursement revenue for each 1 percent drop in the complication rate, according to the article in Health Affairs. In that case, researchers recommended hospitals with "limited growth prospects" form a gain-sharing arrangement with payers to share in any savings from surgical complication reduction programs, FierceHealthcare previously reported.

To learn more:
- read the announcement
- here's the abstract in JAMA
- see the NPR article
- check out the study in Health Affairs

Related Articles:
Study: Hospitals save millions with surgical complication prevention
Healthcare cost–quality association varies
Do hospitals profit from drug discounts meant for poor, uninsured patients?
Flat admissions, reimbursements drive down hospital margins
Repeal of health reform would 'constrain' hospital profits


Thank You Fierce Healthcare and Ms Bird.

"We wouldn't let a drunk physician into the operating room"

No, We wouldn't Want Drunken Surgeons in an Operating Room, ....... BUT:

Study: 15% Of Surgeons Abuse Alcohol

 "Teamwork is vital for efficient care; each professional caregiver possesses unique and equally important expertise that should be shared." 

Hospital Workers Don't Report 86% Of Patient Harm Events

Hospitals Report Only 1% Of Patient Harm Events 

And it continues because the Control mechanism in situ to put the brakes on it is an openly Protectionist farce.

Medical Boards Lack Resources To Punish Dangerous Docs 

State Med Boards Not Punishing Dangerous Docs 

National Database Riddled With Holes: Records Missing On Disciplined Healthcare Workers

Medicine has systemically gotten So lax that not only has the Operating Room become a post 19th Hole good old boys club, but the surgical instruments themselves are becoming an ever more septic hazard. 

Dirty Surgical Tools, A Dangerous, Growing Problem

"But we've seen a lot of hospitals where you say, 'Why aren't you investing in reducing risk, the way other industries do?' "

Oh for Chrissakes, If they Did, they'd also have to toss their Psychiatric Profit Packers clean off the premises.

But in San Francisco, being the Progressive People's Collective it is, they've already embraced that very paradigm and gone it one better. They kicked the Premises off the Premises.

SFMHB 06/13/07 

Gee Whiz, Why would they have done That?
Science For Sale: The Psychrights.org Collection 

"It's been known that hospitals are not rewarded for quality, but it hadn't been recognized exactly how much more money they make when harm is done."

Pic Credits and Thanks to thepeoplescube, for;

Government Issues Study of A Study About Studies

RAMS: Cultural Crapulence In San Francisco

Thank God that RAMS in SF is 'Culturally Competent'. Here's how that Psychiatric Cultural Competence hit the ground.



And here's that APA Kun Po Soo Award Winning Cultural Competent himself, Dr Francis G. Lu, ..... again: the former Top of the Psychiatric Food Chain in San Francisco, and City Hall Mental Health Board meeting Attendee to whom Truth Is a Relative Ideation when there's Millions of Public Dollars being chased.

Yes, This, is the same Cultural Competent whose;

"California Pacific Medical Center, and St. Francis Hospital. These are facilities that physically do not have a psychiatric emergency capability, nor the staff.”

And, just moments Earlier:

"Sutter Health announced in April closure of another 28 locked inpatient beds at CPMC"

, ..... So stunned the Other Supra Mentalists in the room - ALL of them - that they were Stricken Deaf and Dumb on the spot, ...... sort of.

OCAPICA 2004 Annual Report.

































"New partnerships and projects included the Southeast Asian Children's Health Research Project (SEACHRP) and the Diabetes Fellowship. SEACHRP was a partnership with Special Service for Groups, Cambodian Association of America, Families in Good Health, Educated Men With Meaningful Messages (???). and Khmer Girls in Action funded by First 5 Los Angeles to conduct community participatory research exploring the education, health, and social service needs of Southeast Asian children 0 to 5 year of age. The Diabetes Fellowship was a collaboration with Latino Health Access and the Orange County Health Care Agency funded by the Pacific Life Foundation to build the capacity of AAPI community members, leaders, and staff representing community based organizations in Orange County to create advocates trained in diabetes prevention, control and management."

Mental Health: Comes With FREE Diabetes






RAMS (Richmond Area Multi Services) is on the Donor List of an Asians Only Organization in Orange County, 400 Miles south of San Francisco, where they were Donating to help Asians Only OUT of developing Diabetes while they were simultaneously Prescribing Diabetes/Antipsychotics ON Their Premises In SF. And PART of RAMS Funding came from the SFUSD - San Francisco Unified School District.

Were there Culturally Competent 'Differential Diagnoses' concocted for the kids in SF's Unified School District too, or was the Diabetes just prescribed indiscriminately?

Isn't Cultural Competence peddled on the School District's Dime, Simply to Die For?






"Although addictive gambling is devastating," said Dr Chiu "it can be cured with proper counseling."

Well isn't that just special ..... considering that everybody Else is expected to wear those Incurable 'Disorders' for the rest of forever, ...... because these Diagnosers just Know, ..... Because there's Millions of Public Dollars to be snatched up In the Knowing, ...... that they Can't Cure Jack, ..... .

If you think we're Nit Picking, please explain to Yourselves how the DSM grew to contain 374 Different Incurables in it.




Pathological Gambling is an 'Incurable Mental Illness', but at RAMS an Asian Psychologist claimed it's Not Incurable, as long as it's in other Asians.

Does This mean that if we Waste another few Billion training Amish Psychiatrists in the Culturally Competent needs of Amish Citizens that They will never need to fear Bipolar or Schizophrenia again in Pennsylvania?

San Francisco is divided into local Districts. The Districts elect District Supervisors who serve at City Hall as quasi Deputy Mayors. RAMS is located in SF's Richmond District and it's Inordinately proud of it's 'Cultural Competence' in serving the needs of 'Underserved Minority Populations' of Asians and Pacific Islanders.

SF's Richmond District is 64.3% Asian.
















Just exactly When, did 64.3% become a 'Minority' of Anything?



And if you're New here, we're posting this Performance Audit Memo again.

RAMS was holding $16.3 Million in DPH contracts, and you'll get a heady whiff of how utterly misspent Every cent of that money was, & how the State of California came in and Covered it up.

RAMS is Not, an aberration.
RAMS was a 'NATIONAL TRAINING CENTER'.















"When we all work together in serving the community it is truly amazing what we can accomplish."

It certainly is, ..... on the SF Unified School District's Dime.

Are you Sure you want one of these operations springing up in Your town?

You'd better take a closer look, because odds are, you've already got one.

Obama Appoints Socialist To Run Medicare & Medicaid: BYPASSES SENATE HEARING!

Red State.com has;

Donald Berwick Exemplifies The Obama Agenda

Mr Domenech's analysis of this yet further revolting development from the party of "Yes You Will!" is far more than simply apt.

Because This time, even the New York Times isn't buying it.

Thank you Mr Domenech.

Britain's Government-Run Health-Care System Under Fire.

CNSnews.com has:

Britain's Government-Run Health-Care System Under Fire

Go Read It, and hope that British Citizens can Get Rid of this Obnoxious, Inhumane, Cost Cutting, Socialist Dysfunction before it finishes off any More of their family members.

And ask yourself; Why, would we want the Same Disaster here in the States?


There's One, Huge, and very Visible, 100% Incompetent, Disease Mongering Drain on America's Health Care Resources which we could get Rid of Right Now.

Cut the GD Funding Off. All of it.

Hospital Stupidity Costs 85,000 Lives & $35 Billion Per Year

Public Citizen has:

Aug. 6, 2009

Basic Patient Safety Reforms Would Save 85,000 Lives and $35 Billion a Year, Public Citizen Report Says

Consumer Group Urges Congress to Use Medicare Funding as Leverage to Implement Changes

WASHINGTON, D.C. - A report issued today by Public Citizen proposes 10 cost-cutting, patient safety measures that would save an estimated 85,000 lives and $35 billion a year. The report, "Back to Basics," analyzed the results of scientific studies of treatment protocols for chronically recurring, avoidable medical errors.

In contrast to the high-tech tests and procedures that many experts blame for staggering increases in the nation’s health care costs, most of the reforms in Public Citizen’s report involve fundamentals as simple as practitioners consistently washing their hands, sufficiently tending to patients to prevent bed sores, and following simple safety checklists to prevent infections and complications stemming from operations.

Aside from the tragedy of needless deaths and injuries, the financial toll of failing to follow accepted safety procedures is astounding. Severe pressure ulcers cost an average of $70,000 apiece to treat. A catheter infection costs $45,000. Each instance of ventilator-associated pneumonia costs $5,800. Collectively, avoidable surgical errors cost an estimated $20 billion a year, bed sores $11 billion and preventable adverse drug reactions $3.5 billion.

"There are many incentives to order expensive tests and procedures and too few rewards for providing basic, sensible care," said David Arkush, director of Public Citizen’s Congress Watch division. "As the largest investor in the nation’s health care system, the federal government should ensure that fulfilling basic patient safety standards is a condition of receiving federal reimbursements. And the government should pay providers for doing the right thing. It will save money in the long run."

Public Citizen proposes that health care providers:

• Use a checklist to reduce avoidable deaths and injuries resulting from surgical procedures (saves $20 billion a year);

• Use best practices to prevent ventilator-associated pneumonia (saves 32,000 lives and $900 million a year);

• Use best practices to prevent pressure ulcers (saves 14,071 lives and $5.5 billion a year);

• Implement safeguards and quality control measures to reduce medication errors (saves 4,620 lives and $2.3 billion a year);

• Use best practices to prevent patient falls in health care facilities (saves $1.5 billion a year);

• Use a checklist to prevent catheter infections (saves 15,680 lives and $1.3 billion a year);

• Modestly improve nurse staffing ratios (saves 5,000 lives and $242 million a year);

• Permit standing orders to increase flu and pneumococcal vaccinations in the elderly (saves 9,250 lives and $545 million a year);

• Use beta-blockers after heart attacks (saves 3,600 lives and $900,000 a year); and

• Increase use of advanced care planning (saves $3.2 billion a year).

Public Citizen proposes five steps to ensure near-universal adoption of these reforms:

• The federal government should use its enormous leverage from its $750 billion annual investment in health care to compel providers to use proven patient safety practices. The Department of Health and Human Services (HHS) has the authority to enact many of reforms proposed in Public Citizen’s report through the regulatory process. Congress could ensure rapid adoption by including instructions to HHS in legislation;

• Congress should require HHS to take responsibility for accrediting providers to receive Medicare reimbursements. At present, the federal government delegates most accrediting authority to the Joint Commission, a private entity that derives its income from the very hospitals it oversees and denies accreditation to less than 1 percent of these hospitals;

• Congress should make significant financial investments to increase the country’s supply of nurses and set federal minimums of acceptable nurse-to-patient ratios. Nurse shortages are often implicated in patient safety errors. Modest increases would yield significant improvements. A significant increase in the number of nurses could produce dramatic results. One study estimated that increasing the number of nurses by a little more than one-third would save an astounding 72,000 lives annually;

• Congress should require mandatory reporting of adverse events, including requiring hospitals to institute strong internal reporting systems, and creating whistle-blower protections for health care workers. National reporting of the most serious medical errors is largely left to the Joint Commission. However, that organization estimates that it learns of only about one-tenth of 1 percent of serious medical errors despite its stated requirement that doctors disclose all errors to patients. In 1996, the Joint Commission contemplated requiring mandatory reporting but succumbed to industry pressure and settled for voluntary reporting; and

• Congress should ensure that the requirements for hospitals to report doctor discipline and maintain viable peer review processes are followed. Hospitals have been required since 1990 to report to the federal government cases in which doctors are suspended for more than 30 days. But nearly 50 percent of hospitals have never reported a single disciplinary action. This may be due to hospitals flouting the law, evading the spirit of the law by customizing penalties to sail below the reporting threshold, or failing to carry out warranted doctor discipline altogether because of inadequate peer review processes.

READ the report.

###

Thank You Public Citizen.