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Both doctors and hospitals are financially incentivized to avoid rehospitilization. It is actively tracked and directly impacts billing. Check out the "Hospital

by teej 9y ago

Both doctors and hospitals are financially incentivized to avoid rehospitilization. It is actively tracked and directly impacts billing. Check out the "Hospital Readmissions Reduction Program" that Obamacare introduced. I’m sick of people spreading FUD about medical billing based simply on the ridiculous “the man is out to get me” narrative.

SilasX 9y ago
Fair enough -- I was severely understating the extent to which there are financial incentives. But I think you're making a similar error in the opposite direction, coming from the approach of of "that problem is solved because we have a law for it." Imagine in any other context: "Everyone makes a living wage, because we have minimum wage laws." -> No, cost of living can eat it up in some areas, and some people are forced to go contractor, where take-home can get arbitrarily low. "Taxis provide vital, universal service because they're obligated to take you anywhere." -> Yeah, but in practice they can flout this with impunity. In this case, yes, the most obvious cases of hospital failure will be undercompensated, getting some incentives right. But is that the same thing as saying that actual, effective measures to avoid screwing up will translate into higher profits, and the people capable of identifying these will benefit from pointing them out? I think that's a stretch. Why do you think such a simple measure, as proposed by this startup, has to drag them kicking and screaming into implementation? Isn't this something a hundred doctors might have noticed and suggested? Something system level isn't working. Either the feedback loop between hospitals and doctors is broken, or it's too easy to relabel a readmission as being a new issue, or something like that. If startups have that kind of resistance to something so simple, that suggests a lot of easy improvements are still being held up by misaligned incentives, and supports my original point that system level fixes are a bigger target for health outcome returns.

by teej 9y ago

SilasX 9y ago

Fair enough -- I was severely understating the extent to which there are financial incentives. But I think you're making a similar error in the opposite direction, coming from the approach of of "that problem is solved because we have a law for it." Imagine in any other context: "Everyone makes a living wage, because we have minimum wage laws." -> No, cost of living can eat it up in some areas, and some people are forced to go contractor, where take-home can get arbitrarily low. "Taxis provide vital, universal service because they're obligated to take you anywhere." -> Yeah, but in practice they can flout this with impunity. In this case, yes, the most obvious cases of hospital failure will be undercompensated, getting some incentives right. But is that the same thing as saying that actual, effective measures to avoid screwing up will translate into higher profits, and the people capable of identifying these will benefit from pointing them out? I think that's a stretch. Why do you think such a simple measure, as proposed by this startup, has to drag them kicking and screaming into implementation? Isn't this something a hundred doctors might have noticed and suggested? Something system level isn't working. Either the feedback loop between hospitals and doctors is broken, or it's too easy to relabel a readmission as being a new issue, or something like that. If startups have that kind of resistance to something so simple, that suggests a lot of easy improvements are still being held up by misaligned incentives, and supports my original point that system level fixes are a bigger target for health outcome returns.