Study: Teaching Hospitals More Vulnerable to Changes in Medicare Payments

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A new study in the upcoming issue of the journal Medical Care assessed the effects of impending changes to healthcare finance on teaching versus non-teaching hospitals.

 

The study included 2,418 hospitals and compared risk-adjusted readmission and mortality rates for heart attack, congestive heart failure and pneumonia from hospitals that ranked similarly in hospital-level quality-of-care process measures and teaching intensity, which was measured by the resident-to-bed ratio at the institution.

 

When compared on the basis of quality-of-care process indicators, all hospitals performed equally well in readmission and mortality rates for the three conditions.

 

When compared based on teaching intensity, however, hospitals with a higher teaching intensity showed higher readmission and lower mortality rates than hospitals at lower teaching intensities.

 

In addition, hospitals with high teaching intensity and comparably larger Medicaid populations had high readmission rates for heart attack and congestive heart failure.

 

The study authors concluded that teaching and safety-net hospitals, despite lower mortality rates, will be affected disproportionally by changes to Medicare payment structures because of those hospitals' higher readmission rates.

 

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