When it comes to quality improvement, hospitals just can't win for losing

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With a national effort to improve care and cut costs, healthcare providers have a lot of opportunity to explore new innovations and healthcare delivery models--and have a right to be proud of their efforts. Yet some recent articles in FierceHealthcare suggest there are plenty of reasons for those driving these efforts to feel discouraged.

For one thing, despite improved quality scores, some hospitals will still get hit with big Medicare penalties for readmissions.

Hospitals have been implementing quality care improvements, but a lot of those efforts won't stave off reimbursement cuts, since Medicare is basing the first round of penalties on patients who were discharged between July 2008 and June 2011.

Robert Wood Johnson University Hospital in New Jersey, for example, saw a 25 percent drop in readmissions for heart failure and pneumonia after launching a transitional care program in January. But thanks to outdated Medicare data, the hospital still faces 0.85 percent reimbursement cut.

The chief medical officer of North Carolina's Wake Forest Baptist put it best when he told the Winston-Salem Journal, "I'm not sure it is possible to put more focus into our efforts on readmissions."

As FierceHealthcare noted last month, even the so-called winners under the readmission reduction program are losers: Hospitals that avoid the Medicare penalties won't earn any rewards for achieving low readmission rates.

Meanwhile, some hospitals still are seeing low scores for patient safety--and leaders are expressing frustration with methodologies they say fail to reflect their current efforts. The nonprofit Leapfrog Group addressed initial complaints about how it calculates the hospital safety grades, but the scorecards highlight how the industry-wide goals to improve quality sometimes don't give credit to ongoing improvements and progress.

It seems individual providers are falling prey to such discouragement, evidenced by the silent exodus of physicians from healthcare. A majority of physicians in a recent survey expressed pessimism about the future of the medical profession, with 82 percent saying they feel powerless to change the U.S. healthcare system.

It's not all that surprising to read reports that almost half of U.S. physicians suffer from burnout. Let's hope we don't end up with hospitals and entire health systems burning out on increased quality and reimbursement pressure. - Alicia (@FierceHealth)