Penalizing Hospitals For Re-admissions Might Be Counter-Productive

See An ObamaCare Penalty on Hospitals: This approach to reducing Medicare patient readmissions will have unintended consequences by STEPHEN SOUMERAI AND ROSS KOPPEL, from the WSJ, 5-6-2013.Excerpts:

"Research shows that most readmissions can't be prevented.
 
Readmissions are often unavoidable consequence of life-threatening complications that can appear after discharge from the hospital."

"...only about 25% of all readmissions are preventable"

"...patients that are elderly, minority, poorly educated, poor, smokers and the noncompliant (among others) have higher readmission rates."

"Readmission penalties will have unintended consequences that harm patients."

"Hospitals will seek to keep such patients in emergency rooms rather than admit them. Why? The simplest way to avoid readmission is not to admit a patient in the first place." 

"The policy discriminates against poorer hospitals.
 
Small and financially struggling hospitals lack the resources to effectively manage their discharged patients at home."

"...of 2,200 hospitals found that "safety-net" hospitals that treat a higher number of lower-income patients are "30 percent more likely to have 30-day hospital readmission rates above the national average.""

"...rained physician and nurse-practitioner teams can help homebound elderly and heart-failure patients avoid readmissions, sometimes reducing rehospitalizations by nearly 50%."

"...Medicare penalties for hospital infections deemed "preventable" failed to reduce infections. Instead, the penalties contributed to misleading coding to give the appearance of fewer infections."

"...paying doctors extra money for individual quality metrics (like treating high blood pressure) rarely, if ever, works."

Dr. Soumerai is a professor at Harvard Medical School and the Harvard Pilgrim Health Care Institute. Dr. Koppel, a professor of sociology at the University of Pennsylvania, conducts health-care research at Penn and Harvard.