http://www.mikecritelli.com/2008/04/09/health-care-professional-supply-issue/ Mike Critelli's Blog Wed, 20 Aug 2008 02:25:01 +0000 http://wordpress.org/?v=2.3.3 http://www.mikecritelli.com/2008/04/09/health-care-professional-supply-issue/#comment-2608 Russ Briggs Mon, 14 Apr 2008 16:28:44 +0000 http://www.mikecritelli.com/2008/04/09/health-care-professional-supply-issue/#comment-2608 Dear Mike, Your prescription for fixing the healthcare system is right on, provided it is accompanied by the need to find out what the system is actually paying for its mistakes. Our data suggests the cost of one revision of a hospital-acquired infection can run as high as $50,000. Apparently insurers are baulking at reimbursing these costs, on the grounds that it was the hospital that caused the infection, why should the insurer have to pay for that? It is this type of financial pressure that could bring about a sea change in healthcare system behaviour, as the costs finally start to become more inured to the benefits. Some examples: Wellness is a bad spend for insurers because the benefits inure to another time period (maybe 30 or 40 or 50 years removed) and, in all likelihood, serve to reduce another insurer’s medical loss while at the same time increasing their own. A hospital spends money to prevent infection, but is paid no more for doing so in a market where prices are federally set and all others peg to it; to the extent any readmission is cash positive, there are few economic or fiduciary incentives (there are moral incentives) to aggressively invest. (If infection rates were public, the argument goes, then there would be economic benefit for having lower rates since it would presumably give rise to higher market share.) Another example is in surgery, where it is known that surgeons in physician-owned centers will not have the same supply costs (it’s their own money) as they impose on hospitals (where it’s not their money). Keep up the good work, Mike. Dear Mike, Your prescription for fixing the healthcare system is right on, provided it is accompanied by the need to find out what the system is actually paying for its mistakes. Our data suggests the cost of one revision of a hospital-acquired infection can run as high as $50,000. Apparently insurers are baulking at reimbursing these costs, on the grounds that it was the hospital that caused the infection, why should the insurer have to pay for that? It is this type of financial pressure that could bring about a sea change in healthcare system behaviour, as the costs finally start to become more inured to the benefits. Some examples: Wellness is a bad spend for insurers because the benefits inure to another time period (maybe 30 or 40 or 50 years removed) and, in all likelihood, serve to reduce another insurer’s medical loss while at the same time increasing their own. A hospital spends money to prevent infection, but is paid no more for doing so in a market where prices are federally set and all others peg to it; to the extent any readmission is cash positive, there are few economic or fiduciary incentives (there are moral incentives) to aggressively invest. (If infection rates were public, the argument goes, then there would be economic benefit for having lower rates since it would presumably give rise to higher market share.) Another example is in surgery, where it is known that surgeons in physician-owned centers will not have the same supply costs (it’s their own money) as they impose on hospitals (where it’s not their money).
Keep up the good work, Mike.

]]> http://www.mikecritelli.com/2008/04/09/health-care-professional-supply-issue/#comment-2554 John Rathgeber Wed, 09 Apr 2008 17:48:08 +0000 http://www.mikecritelli.com/2008/04/09/health-care-professional-supply-issue/#comment-2554 Mike thank you for continuing to blog on the need for a comprehensive approach to health care reform that includes both incenting life style changes to reduce incidents of preventable cronic diseases and expanding access to quality care. Today's Harvard Crimson (www.crimson.com) has a lead editorial on shortage of primary care doctors and offers ideas for incenting more medical students to pursue those careers. But, it misses the point that you made about the critical role that more nurses and nurse practioners can play in providing quality care. Mike thank you for continuing to blog on the need for a comprehensive approach to health care reform that includes both incenting life style changes to reduce incidents of preventable cronic diseases and expanding access to quality care. Today’s Harvard Crimson (www.crimson.com) has a lead editorial on shortage of primary care doctors and offers ideas for incenting more medical students to pursue those careers. But, it misses the point that you made about the critical role that more nurses and nurse practioners can play in providing quality care.

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