Quality expert: Don’t throw out payment reform baby with Obamacare bathwater

At the Mayo Clinic Transform conference that kicked off Sunday, one theme has emerged surrounding Obamacare and the Affordable Care Act.

That as controversial as Obamacare may be to some, on balance it is actually positive. Richard Gephardt, a Democrat and a former House majority leader, acknowledged that the issue is a lightning rod for some, but said that it’s always better when you grow access.

And on Monday, one speaker described Obamacare and its reimbursement policies, saying that “there is a baby in that bathwater: payment reform.” (Republican presidential candidate Mitt Romney has repeatedly vowed to repeal Obamacare, even though recently Romney did acknowledge that he would keep some parts of the law.)

Laura Adams, president and CEO of the Rhode Island Quality Institute recalled her experience as a nurse early in her career when she accidentally gave a medication overdose to a 7-year-old who almost died. Adams, who is a breast cancer survivor, talked about transforming healthcare by moving away from a system that pays for the wrong things.

“Healthcare is the only industry that bills people for defects and pays people to fix them,” she said Monday, in probably one of the most lucid, simple analyses that called for payment reform.

She added that the type of error that she made was just waiting to happen. In her case, by the time she gave the medication to the child after reading the prescription, it had been hand transcribed six times.

Meanwhile, providers are now being forced to take responsibility for errors given that Centers for Medicare & Medicaid Services has decided not to reimburse hospitals for their own errors related to hospital-acquired infections. Starting Oct. 1, the agency will penalize hospitals for excessive readmission rates.


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