Docs, hospitals should share responsiblity for readmissions

Hospitals may soon have plenty of incentive to lower their readmission rates, with the Obama administration considering doling out bonuses to facilities that can do so, and penalizing those with higher rates. But is this the correct approach to take when it comes to lowering readmission rates? One doctor thinks otherwise. 

Instead of giving out incentives to hospitals with low readmission rates (and penalties to facilities with higher rates), doctors should be included in this process, Dr. Sandeep Jauhar, a cardiologist at a Long Island hospital, argues in an New York Times essay. 

Gainsharing, he believes, would be a much more effective approach to curbing readmissions. "Hospitals do not hospitalize patients; doctors do," he says. "And doctors currently stand to gain little from lowering readmissions." 

According to Jauhar, hospitals already have enough of an incentive to cut readmission rates. "The longer a patient stays in the hospital, the more money the hospital stands to lose," he writes. Chronically ill-frequent fliers also account for 75 percent of healthcare spending, and cost Medicare big time, to the tune of $12 billion to $15 billion per year according to one analysis of 2007 data. 

Doctors, on the other hand, count on multiple visits to hospitalized patients to get paid. Jauhar eludes to a conversation he had with a friend of his in private practice, who told him, "It's OK if you have enough patients in the hospital, but if you don't, you sometimes have to drag out the stay. I don't like to do it, but sometimes you have to." 

To learn more about readmissions:
- read the full essay in the New York Times