AIM Report on LOS

Posted on April 19, 2008 by Dr. David Edward Marcinko MBA MEd CMP™

Briefer Hospital Stays not Always Better

Staff Writers

Briefer hospitalizations are not always best, according to a recent new study published in the Archives of Internal Medicine [AIM].

The PHCCC Study

A study of 15,531 patient medical charts, using hospital billing data from the Pennsylvania Health Care Cost Containment Council [PHCCCC], found that patients diagnosed with a pulmonary embolism [PE] who were discharged after four or fewer days in the hospital, were significantly more likely to die than those who remained in the hospital for five, six or more days. The study was also reported in the Philadelphia Inquirer newspaper.

Assessment

The study sought to determine whether new guidelines that recommend patients identified as being at low-risk for complications be discharged more quickly, were working as intended?

Conclusion

Unfortunately, they apparently weren’t as more than half of those discharged after four days or less had more severe cases.

Now, can this be described as the “ultimate policy in medical cost-containment?” Please comment.

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Disease Management Economics

Posted on April 19, 2008 by Dr. David Edward Marcinko MBA MEd CMP™

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The Medicare Health Support Program

[By Staff Writer]

Doctor

The Medicare Health Support Program [MHSP] is a three-year experiment to determine if disease management [DM] can limit pathology and reduce expensive hospital visits for patients with chronic conditions. These typically include congestive heart failure, asthma and diabetes.

But, a new report suggests that this once highly-touted program may actually cost more than it saves.

Preliminary Outcomes

Since 2005, the Centers for Medicare and Medicaid Services [CMS] paid eight outside companies about $360 million to deliver DM services from nurses who periodically called patients to check on their diets, drug use, blood sugars, exercise patters and doctor appointments, etc.

Now, Medicare is still trying to figure out whether the program was able to keep folks healthier. Unfortunately, the New York Times reported that preliminary data indicates DM is unlikely to save money.

Mixed Opinions

Of course, at least two companies that specialize in disease management, Healthways and Health Dialog, are pressing Medicare to continue the project beyond the end of it term, saying the government mishandled the experiment.

But, CMS says the program so far has not reduced medical bills enough to offset the fees the companies are charging the government [about $2,000 per patient/per year].

Assessment

Final MHSP accounting is likely to come next year. And so, it seems that in this case, education and DM might not be “the best prescription.”

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