|Christmas did not come early this year for Parkland or UTSW as they both received a lump of coal in their|
stockings from Jolly Old Medicare as they are penalized for being on CMS's patient safety naughty list
|The feds are now cracking down on unsafe|
hospitals with penalties, which is bad news
for both Parkland and UT Southwestern
Those aggregate patient quality ratings are based in part on readmissions rates and 24 evidence-based clinical patient quality measures, including mortality rates for patients who are discharged after heart attacks, pneumonia, and chronic heart failure (CHF).
Much like jolly old St. Nick during Christmas, the U.S. Centers for Medicare and Medicaid Services (CMS) last week released its highly-anticipated list of who's been naughty and who's been nice among 3,000 hospitals that treat Medicare recipients.
Hospitals who perform well receive gifts in the form of percentage bonuses, while those who have been naughty receive a lump of coal in the form of percentage penalties.
So guess how Parkland and UT Southwestern hospitals performed.
The breakdown was that Parkland was penalized -0.43 percent in value based purchasing plus -0.03 percent in readmissions penalties, while St. Paul received a -0.25 percent penalty in value based purchasing plus 0.00 percent in readmissions.
It appears that anyone associated with UT Southwestern Medical Center received a lump of coal for being naughty this year.
These substandard results for Parkland and UT Southwestern were not surprising given that both Parkland and St. Paul University Hospital have previously shown up numerous times on the Texas Department of State Health Services (DSHS) list of the ten worst large hospitals in the state for several years now.
Zale Lipshy University Hospital, which was considered too small to be evaluated in the DSHS survey of large hospitals in the state, did however underperformed in the LeapFrog Group's patient safety survey, receiving a D-grade in the last survey they participated in from one year ago.
After UT Southwestern hospitals' poor showings in the LeapFrog survey from November of 2012, UT Southwestern decided they "would no longer participate in the LeapFrog surveys."
|To no one's surprise, Parkland was penalized for underperforming|
in Medicare's new quality rating measures
The rates for bonuses and penalties under the ACA are currently small, but may increase each year until 2015.
In fiscal year 2014, which began on October 1, a hospital could lose as much as 3.25 percent of its Medicare reimbursements, while bonuses could be as high as 1.25 percent. By 2015, hospitals could face up to 5.5 percent in bonuses or penalties, depending on how well they perform.
Medicare is a federal health care insurance program for seniors, the disabled, and also pays for teaching hospitals to train residents-in-training. It may account for roughly two-thirds of all annual revenues at some hospitals.
The rules for Medicaid, the state-run health care insurance program for the poor that is substantially subsided by the feds, are roughly the same as that for Medicare, although Medicaid rates for payment may be substantially lower than those of Medicare.
|Also not surprisingly, UTSW's flagship hospital, St. Paul University Hospital,|
was also dinged for performing poorly on Medicare's new quality assessment tool
One is based on readmission rates of patients who come back to the hospital for the same complaints within weeks or days after their initial hospital discharges. Patients who come back to be hospitalized for the same ailment are counted against hospitals, while those hospitals that keep down their readmission rates are rewarded with bonuses.
The other pay-for-performance area of quality evaluates a hospital's aggregate score of 24 evidence-based patient quality measures.
These measures include mortality rates of patients who are discharged from the hospital after being initially admitted heart attacks, pneumonia, and chronic heart failure. Thirty percent of the second part of the score is based on patient satisfaction, while forty-five percent is based on whether the hospital follows key clinical procedures recognized as being important to patient safety.
The total scores for readmissions and quality are tallied up for bonuses and penalties to the hospitals and were imposed last Thursday.
It seems Christmas didn't come early this year for Parkland or UT Southwestern.
- D-Healthcare Daily: North Texas hospitals penalized under new Medicare program rating system (11/19/13) new!
- DMN: Hospital quality-based Medicare bonus or penalty for 2014 (11/18/13)
- DMN: For hospitals now, quality trumps quantity in Medicare's eyes (11/18/13)
- Kaiser Health News: Interactive chart: Bonuses and penalties for U.S. hospitals (11/14/13) new!
- U.S. News & World Report: Parkland Memorial Hospital (10/30/13)
- D-Healthcare Daily: North Texas hospital patient safety ratings released (10/29/13)
- Star-Telegram: North Texas hospitals among those graded by consultant (10/28/13)
- Not Running a Hospital: Not leaping ahead (10/23/13)
- Orgy of Death: DMN: 16 Dallas-area hospitals slip, 9 rise from group’s safety ratings (10/23/13)
- DMN: 16 Dallas-area hospitals slip, 9 rise form group's safety ratings (10/22/13)
- Orgy of Death: Parkland again plummets in rankings for U.S. News' list of best hospitals in the DFW area (9/28/13)
- U.S. News: Best Hospitals in Dallas-Fort Worth, Texas (2013)
- FierceHealthcare: 6 Hospitals on healthcare's naughty list (12/20/12) flag!
- DMN Biz Beat Blog: Hospital safety ratings cite several in Dallas for poor performance (11/28/12) flag!
- DMN: 5 Dallas-area hospitals receive low safety ratings in national survey (11/28/12) flag!
- DMN: Parkland hit with largest fine in Texas history for patient safety violations (8/31/12)
- DMN Investigative Blog: Texas patient safety check (10/11/12) flag!
- DMN: Five major Dallas hospitals get a grade of C in study by national group (6/12/12) flag!
- DMN Investigative Blog: Several Dallas hospitals get poor marks in new safety report (6/11/12) flag!
- DMN Investigative Blog: Setting the record straight on patient safety (10/21/11)
- DMN Opinion: Ask the Editor: DMN Managing Editor George Rodrigue responds to accusation from UT Southwestern's Dr. Daniel K. Podolsky (10/21/11)
- UTSW: Dr. Podolsky responds to Dallas Morning News coverage of hospital care quality (10/16/11)
- DMN: Parkland in Dallas has been among Texas’ worst hospitals for patient safety for years, analysis shows (10/15/11) flag!
- DMN: How U.S. News could hail Parkland even as inspectors found it deficient (10/15/11) flag!