Feb 1, 2013

Massachusetts Doctors and Hospitals Still Struggle with Apologies

The Boston Globe Magazine published last Sunday a lengthy article on the role of physician apologies in the medical malpractice landscape. The article:
Medical malpractice: Why is it so hard for doctors to apologize?
Fixing a system built on blame and revenge will require bold ways of analyzing mistakes and a radical embrace of openness.
You really should read the full article, but here is an important outtake:
"The misleading image of the doctor besieged by bogus lawsuits dangerously obscures an important fact: The vast majority of major medical errors never see the light of day. A classic 1991 study found that only about 2 percent of patients harmed by medical negligence filed a claim.... Harvard-affiliated hospitals were the target of only 90 malpractice claims relating to children between 2006 and 2010, a period when doctors racked up millions of patient encounters. The vast majority of the medical care at these hospitals is superb, to be sure, but it strains credibility to think that any major academic center makes a harmful mistake so rarely..."

Jan 28, 2013

Will Medicare's Value-based Purchasing Help Drive Accountability at Hospitals?

Boston area hospitals score 50-50 on Medicare's new program that ties payments to quality of care

Jordan Rau writes in The KHN Blog, Capsules, about a recent Kaiser Health News analysis of Medicare's new Value-Based Purchasing program that ties Medicare payments to quality of care.

The study, which included the country’s 212 major health care markets, reveals that hospitals in Fort Wayne, Ind., are faring the best on average while hospitals in Washington, D.C., are doing the worst. Interestingly, data on Boston hospitals shows 50% of hospitals getting a bonus based on performance, and 50% getting a penalty, with no average change in payments.

Below is state level data for Massachusetts, New Hampshire and Rhode Island: 
  • Massachusetts - 54% receiving a bonus, 46% receiving a penalty (of 56 hospitals) with a .01% average change in payments.
  • New Hampshire - 69% receiving a bonus, 31% receiving a penalty (of 13 hospitals) with a .08% average change in payments.
  • Rhode Island - 36% receiving a bonus, 64% receiving a penalty (of 11 hospitals) with a -.10% average change in payments.
You can view how individual hospitals in each regional market did by using KHN’s interactive chart, which allows searching by region. KHN’s new analysis averaged hospital performance in each of those markets. You can read more about the data here.