By Dan Calabrese ——Bio and Archives--November 24, 2017
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Liberals have touted data showing that readmissions have fallen since the penalties took effect in 2013, but the JAMA researchers examined whether quality of care has improved as a result. Their observational study examined 115,245 fee-for-service Medicare beneficiaries hospitalized with heart failure across the U.S. in the four years prior to and first two years following implementation of the program. Researchers found that the 30-day readmission rate (adjusted for patient risk) declined to 18.4% from 20% after the penalties were introduced. Yet the 30-day mortality rate increased to 8.6% from 7.2%—about 5,400 additional deaths per year. Over a one-year period the readmission rate fell by 0.9 percentage points while the mortality rate rose by five. In other words, while fewer patients were being readmitted, many more were dying.
The researchers hypothesize that the penalties might “incentivize hospitals to ‘game’ the system, using strategies such as delaying admissions beyond day 30, increasing observation stays, or shifting inpatient-type care to emergency departments.” These tricks may end up hurting patients. Hospitals with above-average readmissions are also more likely to care for low-income patients and deal with complicated medical cases. They are usually financially strapped due to low Medicaid reimbursements, and the ObamaCare penalties may make it even harder to deliver quality care. ObamaCare effectively enrolled Medicare patients and hospitals without their consent in a mandatory policy experiment—you’ll be better off, trust us—but then neglected to evaluate the adverse effects. A drug trial with the same results would have been shut down long ago.Keep in mind, those 5,400 additional deaths are just among the sample group observed in the study. That's a small sample. No one can say for sure how many times this actually played out across the country. But no one should be surprised it happened. The ObamaCare economic model made it inevitable.
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