{"id":19153,"date":"2023-06-06T22:16:42","date_gmt":"2023-06-07T02:16:42","guid":{"rendered":"https:\/\/ifintechworld.com\/investing\/hospital-quality-reporting-rules-can-backfire-on-patients-researchers-say\/"},"modified":"2023-06-06T22:16:43","modified_gmt":"2023-06-07T02:16:43","slug":"hospital-quality-reporting-rules-can-backfire-on-patients-researchers-say","status":"publish","type":"post","link":"https:\/\/ifintechworld.com\/?p=19153","title":{"rendered":"Hospital quality reporting rules can backfire on patients, researchers say\u00a0"},"content":{"rendered":"
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Rules intended to monitor the quality of hospital care and rein in healthcare costs can have an unhealthy effect on patients, new research suggests.\u00a0<\/p>\n

A group of Johns Hopkins University researchers set out to quantify just how much time and money their academic medical center \u2014 Johns Hopkins Hospital in Baltimore \u2014 spends reporting on hospital quality measures to federal and state regulators and other organizations. The results, published Tuesday in the Journal of the American Medical Association, show that one year\u2019s worth of reporting on quality measures \u2014 162 of them, in total \u2014 required more than 108,000 hours of work and cost more than $5.6 million. That\u2019s excluding any time and money spent on actually improving the hospital\u2019s quality of care.\u00a0<\/p>\n

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As hospitals grind out paperwork on a growing list of quality measures, the burden has become \u201csubstantial and counterproductive, resulting in lower care quality and higher prices for patients,\u201d said Ge Bai, a professor of accounting and health policy and management at Johns Hopkins University and a co-author of the study. \u201cClinicians are dedicating more time to reporting quality and less time for patient care, and hospitals are allocating resources to regulatory compliance instead of patients.\u201d<\/p>\n

Although the quality measures are \u201cwell intentioned,\u201d there\u2019s a general perception that \u201cwe\u2019re spending too much time running around reporting too many things\u201d and not enough time actually improving quality, said Dr. Stephen Berry, who led the study and is the vice chair for quality, safety and service and an associate professor of medicine at Johns Hopkins.\u00a0<\/p>\n

Hospital quality metrics required by regulators or national rating organizations track measures like hospital-acquired infections, in-hospital falls and readmission rates. Requirements to report such measures have become more extensive in recent years, researchers say, amid a broader shift toward payment models that aim to optimize care quality while trimming costs, rather than simply paying providers a set amount for each service.\u00a0<\/p>\n

Under this newer \u201cvalue-based\u201d payment approach, quality measures can offer insights on how much bang payers are getting for their buck, an issue that is getting more scrutiny as healthcare costs climb. U.S. healthcare spending reached $4.3 trillion in 2021, or 18.3% of gross domestic product \u2014 up from $2.7 trillion, or 17.2% of GDP, a decade earlier, according to federal government data.\u00a0<\/p>\n

But the Johns Hopkins study adds to other recent research raising questions about the costs and benefits of pay-for-performance systems in U.S. healthcare. A Medicare incentive payment system, for example, affects reimbursement for hundreds of thousands of U.S. doctors but may not accurately capture the quality of care those doctors provide, Weill Cornell Medical College researchers found in a study published last year in JAMA.<\/p>\n

While the shift to value-based care may be a good move for the country, \u201cwe want to get it right,\u201d Berry said. \u201cWe don\u2019t want providers sitting in front of computers for an hour documenting a single day with a patient,\u201d he said. \u201cI\u2019d rather have the doctor in the room with the patient for a longer period of time and writing about it less.\u201d The time spent on such documentation, he said, \u201cmay be the number one source of frustration among my colleagues.\u201d <\/p>\n

And instead of reining in costs, all the reporting may only be driving costs higher, Bai said.\u00a0<\/p>\n

For the JAMA study, the Johns Hopkins researchers compiled a list of quality measures the hospital reported in 2018 to seven government and national healthcare rating organizations \u2014 including only adult inpatient and emergency department metrics \u2014 and assessed the time staff spent on collecting and validating the data, entering information and other reporting tasks.\u00a0<\/p>\n

The study\u2019s finding of 108,000 hours spent on reporting may be an underestimate, the researchers said. Because of the difficulty of estimating the hours involved, for example, the study doesn\u2019t account for the time doctors spend responding to requests from clinical documentation specialists who review physicians\u2019 notes and often suggest ways to make them more detailed in order to shed additional light on quality, Berry said. For example, a doctor might be asked to specify the type of heart failure a patient suffered, Berry said, purely for quality reporting purposes. Providers\u2019 notes \u201caren\u2019t meant to be 50-page essays on the exact quality of what\u2019s going on,\u201d he said, so a doctor might get thousands of staff requests each year asking for adjustments in documentation for quality reporting.\u00a0<\/p>\n

While the $5.6 million estimated cost of quality reporting is small compared with Johns Hopkins Hospital\u2019s $2.4 billion in annual expenses, the researchers said that such reporting likely consumes a larger share of the budget at smaller hospitals. And extrapolating the findings to the more than 4,000 acute-care nongovernment U.S. hospitals, the findings suggest billions of dollars are spent annually just on reporting quality data, the study said. The costs of that reporting, Bai said, will ultimately pass through to patients.\u00a0<\/p>\n

With little coordination among the various organizations that require quality metrics, different groups may track the same measure using different methodology, which means hospitals can\u2019t just copy and paste their reports, researchers say. \u201cMany quality metrics are duplicative, expensive to generate\u201d and offer no tangible benefit for improving care, Bai said. \u201cPolicymakers must consider the detrimental impact of the current quality reporting requirement on patients. Ultimately, patients will bear the consequences, experiencing lower care quality and higher prices,\u201d she said.<\/p>\n

One way to improve the situation, Berry said, might be to pull quality measures straight out of electronic health records. That approach, he said, would mean \u201cno time spent bugging providers to write things up in their notes in more specific and oftentimes impractical language.\u201d\u00a0\u00a0<\/p>\n<\/p><\/div>\n<\/div>\n

Read the full article here<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Rules intended to monitor the quality of hospital care and rein in healthcare costs can have an unhealthy effect on patients, new research suggests.\u00a0 A group of Johns Hopkins University researchers set out to quantify just how much time and money their academic medical center \u2014 Johns Hopkins Hospital in Baltimore \u2014 spends reporting on […]<\/p>\n","protected":false},"author":1,"featured_media":19154,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"video","meta":{"footnotes":""},"categories":[239],"tags":[83],"class_list":["post-19153","post","type-post","status-publish","format-video","has-post-thumbnail","hentry","category-investing","tag-featured","post_format-post-format-video"],"yoast_head":"\nHospital quality reporting rules can backfire on patients, researchers say\u00a0 | iFintechWorld<\/title>\n<meta name=\"description\" content=\"Rules intended to monitor the quality of hospital care and rein in healthcare costs can have an 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