“Could quality measures be causing deaths?,” by Arthur Allen, Politico
“This morning we’re offering you a report by David Pittman that doctors are avoiding some of the nation’s sickest patients for fear that they’ll get dinged by Medicare or graded poorly on health quality measures. . . . … A recent study found doctors who served higher-risk patients under MACRA’s precursor, the Value-Based Payment Modifier, had lower quality scores, giving them fewer bonuses and more penalties. Doctors worry that if they have too many sick patients they’ll get poor scores, which will make prospective patients think they are bad doctors. “I don’t think there’s a single specialty where you can say risk aversion is absent,” said Keith Naunheim, a professor at Saint Louis University School of Medicine. Read the complete story here.”
LTC Comment (from Stephen A. Moses, President, Center for Long-Term Care Reform):
Another classic case of unintended consequences. Government sets out to reward value instead of volume, but people, especially doctors, aren’t stupid. They respond to incentives. If giving great care to extremely ill patients brings them penalties and costs, maybe they avoid such patients. No good deed goes unpunished.