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Hospital or Patient Accountability: Who Is In Charge of our Health?

The federal government instituted a program (as part of the Affordable Care Act) that financially penalizes hospitals for patient readmissions (for the same condition). Medicare payments to hospitals will be docked each year for millions of dollars. The government states the readmissions are often unnecessary and cost taxpayer’s tens of billions of dollars a year for treatments that should have been caught the first time around or were not followed up adequately.


Hospitals have initiated several types of programs, staff, and processes to try to ensure that patients do not get readmitted. They send patients home with a thick detailed packet of discharge instructions; follow-up with patients, even visit their homes. They offer vouchers for cabs and van shuttles to attend follow-up visits to their sites. Many hospitals are instituting more tracking applications and processes to be alerted if one of their patients has been seen by other hospitals or physician’s in order to keep tabs on their patients. They have staff calling patients regularly to ensure they have filled and are taking prescribed medications.


My question is – is it all worth it? Clearly hospitals are going to do whatever they have to in order to retain the charged fees for their services. Ultimately, they have to pay their bills, doctors, technicians; people that conduct the services, along with the tools, medicines, etc.


In short, I view this as the government holding hospitals, i.e., doctors, nurses, and other providers, responsible for the actions of their patients. Have you ever been told by your doctor to lose weight and exercise more? My guess is – yes! We have all been told to do something to improve our health. Did you do it? When you made that next annual visit, had you lost weight? Were you more flexible or stronger?


Of course, when we are sick, we are glad to take that pill that is going to make us better. It is usually just a short period of time and poof! we are all better! But so much of our health depends on proper, long-term care, eating right, not eating too much, limiting alcohol consumption, exercising. How can the hospital or our provider make sure that we do that?


Don’t get me wrong – incentives are great but until the incentives directly impact the patient, I am not convinced that this new program will ultimately do what is intended. Perhaps, the hospitals and physicians will start penalizing their patients for not doing what was prescribed? Certainly something to consider.


No doubt the federal government is trying to protect the hard-earned dollars called taxes that supply the funds for programs like Medicare. As a taxpayer, I appreciate that. The truth is until we can determine why we don’t do what we know is good for us and stop doing what is not so good for us, I am not sure where programs like this will lead.


Ask yourself – where am I on those New Years resolutions? 😊


(IBJ 10/5/18 article entitled “Hospitals hit with fines over patient readmissions – Health Care providers struggle to lower rates” by John Russell)

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